Erythropoietin in the treatment of iron deficiency anemia during pregnancy

The aim of this study was to investigate the efficacy of recombinant human erythropoietin (rHuEPO) combined with parenteral iron, in the treatment of moderate and severe iron deficiency anemia during pregnancy. Twenty-six pre gnant women, who had been ineffectively treated with iron supplementation a lone for at least 8 weeks, were enrolled. They met the following criteria f or inclusion in the study: hemoglobin (Hb) concentration <8.5 g/dl, evidenc e of iron deficiency anemia, and absence of other pregnancy complications, or severe systemic diseases. The treatment protocol comprised of a combinat ion therapy with 150 IU/kg rHuEPO subcutaneously th ree times per week a nd 100 mg parenteral iron daily, for a total period of 4 weeks. Nineteen out of 26 women (73%) showed a quick response, with Hb reaching normal levels w ithin the first 2 weeks of treatment. They displayed an average of 3.17 g/d l increase in Hb concentration during the total period of therapy, with 3.0 g/dl increase with in th e fi rst 2 weeks. In 5 women (19.2 %) there was n o significant increase in Hb levels, while in 2 women (7.6%) a further decl ine in Hb concentration was observed, that necessitated a blood transfusion . In conclusion, rHuEPO combined with parenteral iron is an effective treat ment for moderate and severe iron deficiency anemia during pregnancy, with minimal adverse or side effects. It may serve as an alternative to blood tr ansfusion, or in cases of resistant anemia that are not effectively treated by iron supplementation alone. However, further studies are needed to inve stigate the poor response observed in about 25% of treated patients. Copyri ght (C) 2001 S.Karger AG, Basel.