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Record W2809375791 · doi:10.1186/s12978-018-0536-1

Commentary: Iron deficiency of pregnancy - a new approach involving intravenous iron

2018· letter· en· W2809375791 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

fundA Canadian funder is recorded on the work.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueReproductive Health · 2018
Typeletter
Languageen
FieldMedicine
TopicIron Metabolism and Disorders
Canadian institutionsnot available
FundersUniversity of British ColumbiaBill and Melinda Gates Foundation
KeywordsMedicinePregnancyIron deficiencyAnemiaHepcidinIron-deficiency anemiaIncidence (geometry)Adverse effectPhysiologyObstetricsPediatricsInternal medicine

Abstract

fetched live from OpenAlex

Iron deficiency anemia of pregnancy is common, especially in South Asia, and is associated with adverse maternal and fetal outcomes including increased incidences of maternal mortality, preterm labor and low birth weight. Screening for anemia alone is not sufficient to diagnose iron deficiency. Iron deficiency in neonates is associated with a statistically significant increment in cognitive and behavioral abnormalities which persist after iron repletion. Oral iron is the frontline standard but is associated with an unacceptably high incidence of gastrointestinal adverse events leading to poor adherence. Prospective evidence reports an incidence of neonatal iron deficiency up to 45% even with oral iron supplementation. New evidence reports oral iron ingestion increases serum hepcidin leading to decreased absorption suggesting further decreasing efficacy. Published evidence reports that intravenous iron is safe and effective in the second and third trimesters of pregnancy. Intravenous iron is the preferred route when there is oral iron intolerance or in those situations where oral iron is ineffective or harmful. Intravenous iron is also preferred if the anemia is severe (< 8 g/dL) in the second trimester or at any time in the third trimester when there is little expectation that adequate quantities of iron will be delivered to the fetus as iron requirements increase in each trimester. Guidelines for maternal and neonatal screening and treatment lack consistency and differ between the United States and Europe. New formulations of intravenous iron with complex carbohydrate cores that bind elemental iron more tightly mitigating the release of large quantities of labile free iron allow the administration of complete replacement doses in 15-60 min. The preponderance of published evidence suggests that intravenous iron is underutilized in pregnancy and guidelines suggesting there is insufficient evidence to recommend the routine screening and treatment of iron deficiency in gravidas should be revisited. The major recommendation from this commentary is that in low-income countries, a trial or demonstration project to test the efficacy, safety, cost and feasibility of the administration of intravenous iron to anemic and/or iron-deficient women be undertaken.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.053
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.036
GPT teacher head0.298
Teacher spread0.263 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it