title: Efficacy and safety of adjuvant recombinant human erythropoietin and ferrous sulfate as treatment for iron deficiency anemia during the third trimester of pregnancy.
abstract: OBJECTIVE
  Gestational anemia increases the incidence of maternal and fetal complications. Adjuvant recombinant human erythropoietin (rHuEPO) has been used in patients who refuse blood transfusions, have a low response to treatment with iron sulfate, have limited time before birth, or have other illnesses that complicate the anemia. We demonstrated that the use of adjuvant rHuEPO with iron sulfate reduces the anemia time period and is innocuous to the fetus.
  
  
  METHODS
  An experimental longitudinal prospective study; 100 pregnant women in their third trimester were included. Group 1 (n=50) was set as control for prevalence of anemia and establish hematological maternal and fetal parameters at delivery for our population; 50 women diagnosed with iron deficiency anemia were randomly assigned to treatment groups. Group 2 (n=25) third trimester women with a hemoglobin of <11g/dL were treated with iron sulfate, 600mg administered orally daily for 4 weeks, evaluating the hematologic response for the mother weekly and for both mother and fetus at birth; Group 3 (n=25) women similar to group 2, treated in addition with adjuvant rHuEPO, 4000 units subcutaneously, three times a week, for 4 weeks evaluating the same parameters.
  
  
  RESULTS
  Group 2 and 3 showed a corrected anemia before delivery (mean 11.1 vs 11.4g/dL), but Group 3 showed a statistically broader and more rapid increase in hemoglobin (1.22 vs 1.92g/dL, p value 0.013) with an rHuEPO dose of 4000 units, three times a week for 1 month. No clinical or hematologic difference or changes in growth were observed in the fetus.
  
  
  CONCLUSIONS
  Erythropoietin is safe and effective for both mother and fetus, although an ideal pregnancy dose has not yet been established.
authors: Department of Gynecology and Obstetrics, General Hospital of Ciudad Victoria "Dr. Norberto Treviño Zapata", Ciudad Victoria, Tamaulipas, Mexico. Electronic address: rodrigosanchezgzz@hotmail.com.
authors: Luis Rodrigo
authors: LR
authors: Sanchez-Gonzalez
authors: Department of Gynecology and Obstetrics, General Hospital of Ciudad Victoria "Dr. Norberto Treviño Zapata", Ciudad Victoria, Tamaulipas, Mexico.
authors: Simón Enrique
authors: SE
authors: Castro-Melendez
authors: Department of Gynecology and Obstetrics, General Hospital of Ciudad Victoria "Dr. Norberto Treviño Zapata", Ciudad Victoria, Tamaulipas, Mexico.
authors: Alejandra Cristina
authors: AC
authors: Angeles-Torres
authors: Department of Anesthesiology, General Hospital of Ciudad Victoria "Dr. Norberto Treviño Zapata", Ciudad Victoria, Tamaulipas, Mexico.
authors: Nohemi
authors: N
authors: Castro-Cortina
authors: Department of Gynecology and Obstetrics, General Hospital of Ciudad Victoria "Dr. Norberto Treviño Zapata", Ciudad Victoria, Tamaulipas, Mexico.
authors: Alfredo
authors: A
authors: Escobar-Valencia
authors: Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.
authors: Alejandro
authors: A
authors: Quiroga-Garza
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005296:Ferrous Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000097:blood; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: C554270:EPO protein, human; D005296:Ferrous Compounds; D011994:Recombinant Proteins; D004921:Erythropoietin; C020748:ferrous sulfate
keywords: Adjuvant human erythropoietin; Anemia; Anemia treatment; Gestational anemia; Iron sulfate; Pregnancy