surgumedВестник СурГУ. МедицинаVestnik SurGU. Meditsina2949-3447Сургутский государственный университет10.35266/2949-3447-2026-2-9surgumed-1012Research ArticleМЕДИКО-БИОЛОГИЧЕСКИЕ НАУКИ. ОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕLIFE SCIENCES. ORIGINAL RESEARCHСРАВНИТЕЛЬНАЯ ЭФФЕКТИВНОСТЬ КОМБИНИРОВАННОЙ И ПЕРОРАЛЬНОЙ ФЕРРОТЕРАПИИ ЖЕЛЕЗОДЕФИЦИТНОЙ АНЕМИИ У БЕРЕМЕННЫХEFFICACY COMPARISON OF COMBINED AND ORAL IRON THERAPY FOR IRON DEFICIENCY ANEMIA IN PREGNANT WOMENhttps://orcid.org/0000-0001-6995-4863БелоцерковцеваЛ. Д.BelotserkovtsevaL. D.

доктор медицинских наук, профессор, президент

Doctor of Sciences (Medicine), Professor, President

https://orcid.org/0009-0009-2204-0621ЗининВ. Н.ZininV. N.

кандидат медицинских наук, заведующий отделением гравитационной хирургии крови

Candidate of Sciences (Medicine), Head of the Gravitational Blood Surgery Department

https://orcid.org/0000-0001-8292-1820ИванниковС. Е.IvannikovS. E.

кандидат медицинских наук, доцент

Candidate of Sciences (Medicine), Docent

https://orcid.org/0000-0002-6976-4290КельдасоваМ. Р.KeldasovaM. R.

аспирант

Postgraduate

keldasova.manetli@gmail.comСургутский окружной клинический центр охраны материнства и детства, Сургут; Сургутский государственный университет, СургутРоссияSurgut District Clinical Center of Maternity and Childhood Health Care, Surgut; Surgut State University, SurgutRussian FederationСургутский окружной клинический центр охраны материнства и детства, СургутРоссияSurgut District Clinical Center of Maternity and Childhood Health Care, SurgutRussian Federation2026030720261927888Copyright © Белоцерковцева Л.Д., Зинин В.Н., Иванников С.Е., Кельдасова М.Р., 20262026Белоцерковцева Л.Д., Зинин В.Н., Иванников С.Е., Кельдасова М.Р.Belotserkovtseva L.D., Zinin V.N., Ivannikov S.E., Keldasova M.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgumed.ru/jour/article/view/1012

Железодефицитная анемия остается одной из наиболее значимых медико-социальных проблем в мире. Цель исследования – сравнить эффективность воздействия комбинированной терапии и монотерапии пероральными препаратами железа на течение беременности, родов и неонатальных исходов у беременных с железодефицитной анемией. Проведено проспективное исследование 149 беременных женщин с железодефицитной анемией, которые были распределены на 2 группы: основная (n = 121): получала комбинированную терапию (пероральные и парентеральные препараты железа); контрольная группа (n = 28) получала только пероральную терапию. Сравнивали особенности течения беременности, исходы родов, состояние новорожденных, включая ферритин и гемоглобин пуповинной крови. Комбинированная терапия снижает частоту встречаемости развития инфекции мочевыводящих путей (5,8 % vs 21,4 %, p < 0,05) преждевременного разрыва плодных оболочек (7,4 % vs 21,4 %, p < 0,05). Пероральная терапия повышает вероятность развития послеродового кровотечения (14,3 % vs 5 %, p = 0,093) и потребность в гемотрансфузии (25,0 % vs 3,3 %, p < 0,001) и использовании парентеральной коррекции железодефицитной анемии (10,7 % vs 1,7 %, p = 0,046). Эффективность комбинированной терапии подтверждается лабораторными показателями: более высокий уровень гемоглобина до родов и в послеродовом периоде (p < 0,001). Различия в уровнях гемоглобина (159,4 vs 156,2 г/л, p = 0,394) и ферритин (104,3 vs 186,0 мкг/л, p = 0,108) пуповинной крови у новорожденных между группами не достигли статистической значимости, что не позволяет сделать вывод о преимуществах комбинированной терапии для неонатального статуса железа. Дальнейшие исследования с оценкой отдаленных неврологических исходов необходимы для установления влияния режима ферротерапии на постнатальное развитие.

Iron deficiency anemia (IDA) remains one of the most relevant medical and social issues globally. The article aims to compare the effect of combined iron therapy and monotherapy via oral iron drugs on the pregnancy course, labor, and neonatal outcomes in women with IDA. Involving 149 pregnant women with the specified pathology, the authors carried out a prospective study. The examined were divided into 2 groups: the main group (n = 121) was treated using combined therapy (oral and parenteral iron medications); the control group (n = 28) received oral therapy only. The paper evaluates the groups’ peculiarities in the pregnancy course, labor outcomes, neonate medical condition, including cord blood ferritin and hemoglobin. The research reveals that combined therapy reduces the incidence of urinary tract infections (5.8% versus 21.4%, p < 0.05) and premature rupture of membranes (7.4% versus 21.4%, p < 0.05). In contrast, oral therapy increases the risk of postpartum hemorrhage (14.3% versus 5%, p = 0.093) with the subsequent need for blood transfusion (25.0% versus 3.3%, p < 0.001) and parenteral iron therapy for IDA (10.7% versus 1.7%, p = 0.046). The combined therapy efficacy is confirmed by the following laboratory values: a higher Hb level in the antepartum and postpartum period (p < 0.001). The absence of statistically notable differences in hemoglobin (159.4 versus 156.2 g/L, p = 0.394) and ferritin (104.3 versus 186.0 μg/L, p = 0.108) levels in umbilical cord blood between the studied groups indicates that combined therapy does not significantly improve neonatal iron status. Further studies evaluating long-term neurological outcomes are needed to determine the effect of iron therapy on postnatal development.

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The authors declare that there are no conflicts of interest present.