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Oral Concurrent Session 4 - Health Equity and Policy
Oral Concurrent Sessions
Expedited Sessions
Our aim was to evaluate if a public health effort of directly dispensing, rather than recommending or prescribing, supplements with iron at prenatal visits in a medically underserved community improved hematologic indices, reduced anemia, and blood transfusion.
Study Design:
Beginning on 9/25/2019, a prenatal vitamin with iron (Folivane) was dispensed to all prenatal patients at their prenatal clinic visits. To evaluate the impact of this practice change, patients delivering between 5/13/2020-12/13/2020 and thus having received Folivane prior to 10 weeks were compared to those delivering 1/1/2019-8/1/2019 before Folivane was dispensed in the clinics. Maternal hematocrit (28-32 weeks, delivery admission and discharge), rates of anemia (hematocrit < 30%), and postpartum transfusion for acute blood loss anemia were compared using chi square and ANOVA with P< 0.05 considered significant.
Results:
Maternal hematocrit was significantly higher at all time points among patients who were given Folivane (Table). Anemia rates were significantly lower among patients receiving Folivane at all time points (Table, Figure). In pre-Folivane patients, 18% had anemia on admission for delivery compared to 11% after having Folivane dispensed (p < 0.001). Initiation of Folivane < 13 or < 20 weeks did not change the overall findings. Postpartum transfusion for acute blood loss anemia was reduced by one-third, thus significantly lower in the patients receiving Folivane (Table).
Conclusion:
Directly dispensing iron supplements to pregnant patients at prenatal visits significantly improved hematocrit levels, decreased rates of anemia, and thus translated to a significant reduction of transfusions unrelated to obstetric catastrophes.
.jpg "Lisa R. Thiele, BS (she/her/hers) photo")
Lisa R. Thiele, BS (she/her/hers)
Medical Student
UT Southwestern Medical Center
Dallas, Texas, United States
Elaine L. Duryea, MD
Assistant Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Alexandra S. Ragsdale, MD (she/her/hers)
Fellow Physician
Saint Louis University School of Medicine
St. Louis, Missouri, United States
Carrie Berge, MS, Pharm D
Parkland Health
Dallas, TX, United States
Donald D. McIntire, PhD
University of Texas Southwestern Medical Center
Dallas, Texas, United States
David B. Nelson, MD
Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Catherine Y. Spong, MD
Professor and Chair
University of Texas Southwestern Medical Center
Dallas, Texas, United States