Estrategias de tratamiento en anemia gestacional por deficit de hierro: revisión narrativa de la literatura
Treatment strategies in gestational anemia due to iron deficiency: narrative review of the literature
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La anemia en el embarazo es una condición médica común, fácil de manejar por los profesionales de la salud de cualquier nivel de atención. Objetivo: presentar opciones terapéuticas para la anemia gestacional e identificar las formas de prevenirla. Métodos: se hizo una revisión narrativa de la literatura en diferentes bases de datos electrónicas (MEDLINE vía PubMed, SCOPUS, ISI Web of Science y Cochrane CENTRAL, entre otras), por medio de términos de búsqueda libres y estandarizados; entre 1990 y 2023. Se incluyeron ensayos clínicos, estudios observacionales, casos y controles, revisiones sistemáticas y metanálisis. Resultados: se eligieron para esta revisión 103 publicaciones. Las intervenciones dietéticas recomendadas para prevenir la anemia gestacional deben incluir una mayor ingesta de hierro y vitamina C. El uso de suplementos de hierro se asoció con mejores niveles séricos de hierro. La biodisponibilidad del hierro oral es baja; muchas veces es ineficaz para prevenir y tratar el déficit de hierro, además, con frecuencia provoca efectos gastrointestinales. Las formulaciones de hierro intravenoso administradas en una serie de dosis única o múltiple son una opción disponible. Conclusiones: la terapéutica de la anemia gestacional debe alinearse con su causa; esta debe apuntar a reponer los déficits de hierro mediante la administración oral y/o intravenosa. El patrón dietético y el uso de suplementos de hierro se identificaron como factores preventivos. La suplementación prenatal de hierro ha de individualizarse teniendo en cuenta las reservas maternas de hierro, así como otras condiciones biológicas.
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