Antenatal anaemia is associated with increased peripartum transfusion requirement in South Africa. We studied whether HIV was associated with response to treatment of iron deficiency anaemia.
Prospective cohort study.
Hospital‐based antenatal anaemia clinic in South Africa
Population or Sample
Equal‐sized cohorts of HIV positive (HIV+) and negative (HIV‐) pregnant women with iron deficiency anaemia.
Haemoglobin trajectories of women with confirmed iron deficiency anaemia (ferritin < 50 ng/mL) were estimated from initiation of iron supplementation using mixed‐effects modeling, adjusted for baseline HIV status, ferritin level, maternal and gestational ages and time‐varying iron supplementation.
Main Outcome Measures
Of 469 women enrolled, 51% were HIV+ of whom 90% were on antiretroviral therapy (mean CD4+ lymphocyte count 403 cells/mm3). Anaemia diagnoses did not differ by HIV status. 400 women with iron deficiency anaemia were followed during treatment with oral or intravenous (6%) iron therapy. In multivariable analysis, haemoglobin recovery was 0.10 g/dL ‐per week slower on average in HIV+ vs HIV‐ women (p = 0.001); was 0.01 g/dL per week slower in women with higher baseline ferritin (p<0.001) and 0.06 g/dL per week faster in those compliant with oral iron therapy (p= 0.002).
Compared to HIV‐ women, HIV+ women with iron deficiency anaemia had slower but successful haemoglobin recovery after iron therapy. Earlier effective management of iron deficiency could reduce the incidence of peripartum blood transfusion.