RESUMO
Objective: We conducted a meta-analysis of randomized clinical trials evaluating the clinical effects of ferric carboxymaltose therapy compared to other intravenous iron in improving hemoglobin and serum ferritin in pregnant women. We also assessed the safety of ferric carboxymaltose vs. other intravenous iron. Data source: EMBASE, PubMed, and Web of Science were searched for trials related to ferric carboxymaltose in pregnant women, published between 2005 and 2021. We also reviewed articles from google scholar. The keywords "ferric carboxymaltose," "FCM," "intravenous," "randomized," "pregnancy," "quality of life," and "neonatal outcomes" were used to search the literature. The search was limited to pregnant women. Selection of studies: Studies related to ferric carboxymaltose in pregnancy were scanned. Observational studies, review articles, and case reports were excluded. Randomized studies in pregnant women involving ferric carboxymaltose and other intravenous iron formulations were shortlisted. Of 256 studies, nine randomized control trials were selected. Data collection: Two reviewers independently extracted data from nine selected trials. Data synthesis: The final effect size for increase in hemoglobin after treatment was significant for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 0.89g/dl [95% confidence interval 0.27,1.51]). The final effect size for the increase in ferritin after treatment was more for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 22.53µg/L [-7.26, 52.33]). No serious adverse events were reported with ferric carboxymaltose or other intravenous iron. Conclusion: Ferric carboxymaltose demonstrated better efficacy than other intravenous iron in increasing hemoglobin and ferritin levels in treating iron deficiency anemia in pregnant women.
Assuntos
Anemia Ferropriva , Compostos Férricos , Maltose , Complicações Hematológicas na Gravidez , Humanos , Feminino , Compostos Férricos/administração & dosagem , Compostos Férricos/uso terapêutico , Gravidez , Maltose/análogos & derivados , Maltose/administração & dosagem , Maltose/uso terapêutico , Anemia Ferropriva/tratamento farmacológico , Complicações Hematológicas na Gravidez/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Administração Intravenosa , Ferritinas/sangue , Hemoglobinas/análiseRESUMO
Abstract Objective: We conducted a meta-analysis of randomized clinical trials evaluating the clinical effects of ferric carboxymaltose therapy compared to other intravenous iron in improving hemoglobin and serum ferritin in pregnant women. We also assessed the safety of ferric carboxymaltose vs. other intravenous iron. Data source: EMBASE, PubMed, and Web of Science were searched for trials related to ferric carboxymaltose in pregnant women, published between 2005 and 2021. We also reviewed articles from google scholar. The keywords "ferric carboxymaltose," "FCM," "intravenous," "randomized," "pregnancy," "quality of life," and "neonatal outcomes" were used to search the literature. The search was limited to pregnant women. Selection of studies: Studies related to ferric carboxymaltose in pregnancy were scanned. Observational studies, review articles, and case reports were excluded. Randomized studies in pregnant women involving ferric carboxymaltose and other intravenous iron formulations were shortlisted. Of 256 studies, nine randomized control trials were selected. Data collection: Two reviewers independently extracted data from nine selected trials Data synthesis: The final effect size for increase in hemoglobin after treatment was significant for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 0.89g/dl [95% confidence interval 0.27,1.51]). The final effect size for the increase in ferritin after treatment was more for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 22.53µg/L [-7.26, 52.33]). No serious adverse events were reported with ferric carboxymaltose or other intravenous iron. Conclusion: Ferric carboxymaltose demonstrated better efficacy than other intravenous iron in increasing hemoglobin and ferritin levels in treating iron deficiency anemia in pregnant women.
RESUMO
The phylogenetic, ontogenetic and seasonal hypotheses on the annual periodicity of menarche were tested. Data from European, Asian (Caucasian, Mongolian and Caucaso-Mongolian people from the northern hemisphere) and Chilean (Caucaso-Amerindian from the southern hemisphere) populations were compared with data from Hungary (Caucaso-Mongolian Europeans from a northern temperature zone) and Madras, India (a complex ethnically originated people from a tropical northern area). Chileans were compared with those Caucaso-Mongolian people because Amerindians belong also to the Mongolian group. Hungarian girls showed peaks of menarche in the month of January (winter), June, July and August (summer), in contradiction with most European Caucasians who showed peaks only in winter months; and in agreement with Finns who showed both peaks. Indian girls had peaks in April, May and June (summer) and more extreme peaks and troughs than the Finnish girls (from a temperature arctic zone). These findings do not agree with the seasonal hypothesis, but they do with the phylogenetic hypothesis. Indian girls had a peak of menarche in the same month of birth and the arrangement of data according to the gestational-menarche coincidence showed a significant heterogeneity for the monthly peaks of menarche; thus, the ontogenetic hypothesis was also supported.
Assuntos
Povo Asiático/genética , Fertilização/fisiologia , Menarca/fisiologia , Menstruação/fisiologia , Filogenia , População Branca/genética , Adolescente , Adulto , Criança , Feminino , Humanos , Menarca/etnologiaRESUMO
The phylogenetic, ontogenetic and seasonal hypotheses on the annual periodicity of menarche were tested. Data from European, Asian (Caucasian, Mongolian and Caucaso-Mongolian people from the northern hemisphere) and Chilean (Caucaso-Amerindian from the southern hemisphere) populations were compared with data from Hungary (Caucaso-Mongolian Europeans from a northern temperature zone) and Madras, India (a complex ethnically originated people from a tropical northern area). Chileans were compared with those Caucaso-Mongolian people because Amerindians belong also to the Mongolian group. Hungarian girls showed peaks of menarche in the month of January (winter), June, July and August (summer), in contradiction with most European Caucasians who showed peaks only in winter months; and in agreement with Finns who showed both peaks. Indian girls had peaks in April, May and June (summer) and more extreme peaks and troughs than the Finnish girls (from a temperature arctic zone). These findings do not agree with the seasonal hypothesis, but they do with the phylogenetic hypothesis. Indian girls had a peak of menarche in the same month of birth and the arrangement of data according to the gestational-menarche coincidence showed a significant heterogeneity for the monthly peaks of menarche; thus, the ontogenetic hypothesis was also supported