Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

The Ferinject referral form: Does a structured request form improve compliance with hospital guidelines for iron infusions? (#72)

Scott T Cullen 1 , Geraldine Masson 1
  1. Barwon Health, GEELONG, VIC, Australia

Iron deficiency is one of the most common problems encountered in antenatal care, with approximately 18% of pregnancies experiencing iron deficiency without anaemia1, and 38% experiencing iron deficiency anaemia2. Iron is known to be critical for both maternal, foetal and neonatal morbidity and mortality, with foetal/neonatal iron deficiency influencing long term neurological outcomes.3 The two treatment modalities for iron deficiency are oral and parenteral, both of which have a role in the management of iron deficiency in pregnancy. Oral therapy is the mainstay of treatment. Parenteral iron reserved for patients who do not respond to oral therapy, or are inappropriate for oral therapy. This study aims to determine the efficacy of a structured request form to increase compliance with hospital iron therapy guidelines, and decrease inappropriate iron infusions. A two month period of iron infusions were audited against the hospital iron therapy guidelines to determine baseline compliance. Only 35% of iron infusions met the hospital guidelines. Prior to iron infusion only 44% of patients received an adequate trial of oral iron. Of those patients commenced on oral iron, only 53% had been compliant. The ferinject referral form led to a 27% increase in compliance with hospital guidelines (p=o.o53) and a reduction in total number of iron infusions by 52%, as well as a reduction in infusions for iron deficiency compared to iron deficiency anaemia p=0.14.

  1. Mei Z, Cogswell ME, Looker AC, et al. Assessment of iron status in US pregnant women from the National Health and Nutrition Examination Survey (NHANES), 1999–2006. Am J Clin Nutr 2011; 93: 1312-1320
  2. Stevens GA, Finucane MM, De-Regil LM, et al. The Nutrition Impact Model Study Group (Anaemia) Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health 2013; 1: e16-e25
  3. Lozoff B, Beard J, Connor J, et al. Long-lasting neural and behavioural effects of early iron deficiency in infancy. Nutr Rev 2006; 64: S34-43