美国预防服务工作组 (US Preventive Services Task Forc) 推荐
美国预防服务工作组 (US Preventive Services Task Force, USPTF) 得出的结论是,没有足够的证据支持推荐对妊娠女性进行 IDA 常规筛查或对此群体进行常规补铁(在没有已知 IDA 的情况下)。[65]US Preventative Services Task Force. Iron deficiency anemia in pregnant women: screening and supplementation. September 2015. http://www.uspreventiveservicestaskforce.org (last accessed 21 February 2017).http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/iron-deficiency-anemia-in-pregnant-women-screening-and-supplementation 此结论是基于,估计妊娠女性当前 IDA 患病率的数据缺乏。此外,该工作组还总结道,同样没有足够的证据支持推荐对生活在美国、年龄为 6-24 个月且无 IDA 症状的儿童进行常规缺铁筛查。[66]US Preventative Services Task Force. Iron deficiency anemia in young children: screening. September 2015. http://www.uspreventiveservicestaskforce.org (last accessed 21 February 2017).http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/iron-deficiency-anemia-in-young-children-screening[67]Cantor AG, Bougatsos C, Dana T, et al. Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the US Preventive Services Task Force. Ann Intern Med. 2015;162:566-576.http://annals.org/article.aspx?articleid=2212247http://www.ncbi.nlm.nih.gov/pubmed/25820661?tool=bestpractice.com
美国疾病预防控制中心 (CDC)
CDC 推荐在婴儿、学龄前儿童、妊娠女性及育龄女性等高风险群体中定期进行血红蛋白检查,以筛查贫血。[6]Centers for Disease Control and Prevention. Recommendations to prevent and control iron deficiency in the United States. MMWR Recomm Rep. 1998;47:1-36.http://www.ncbi.nlm.nih.gov/pubmed/9563847?tool=bestpractice.com CDC 同时推荐妊娠期间每天常规补铁 30 mg 以补充铁需求量的增加。这些推荐类似于美国儿科学会 (American Academy of Pediatrics) 和美国妇产科医师学会 (American College of Obstetricians and Gynecologists) 的推荐。[68]American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 95: anemia in pregnancy. Obstet Gynecol. 2008;112:201-207.http://www.ncbi.nlm.nih.gov/pubmed/18591330?tool=bestpractice.com
美国家庭医生协会 (American Association of Family Practitioners, AAFP)
AAFP 得出的结论是,在预防不良母体健康和出生结局方面,没有足够的证据来评估妊娠女性接受缺铁性贫血筛查的获益与危害的平衡。此外,AAFP 还总结道,在评估 6-24 个月儿童接受缺铁性贫血筛查的获益与危害的平衡方面,没有足够的证据。[69]American Academy of Family Physicians. Summary of recommendations for clinical preventive services. January 2016. http://www.aafp.org (last accessed 21 February 2017).http://www.aafp.org/dam/AAFP/documents/patient_care/clinical_recommendations/cps-recommendations.pdf
世界卫生组织 (WHO) 和联合国 (UN) 的推荐
WHO 和联合国推荐在妊娠和哺乳期妇女以及低出生体重儿常规补铁。同时推荐若贫血患病率超过 40%,则在育龄妇女包括青春期少女和学龄儿童中补铁。它们推荐仅在贫血患病率低于 20% 且有治疗方案和行动指南可用时进行 IDA 筛查。[48]WHO, UNICEF, UNU. Iron deficiency anaemia: assessment, prevention, and control. WHO/NHD/01.3. Geneva, Switzerland: World Health Organization; 2001.http://whqlibdoc.who.int/hq/2001/WHO_NHD_01.3.pdf 虽然以前曾经提出补铁可增加疟疾流行国家/地区的疟疾和死亡风险,但目前 WHO 声明,应对生活在疟疾流行国家/地区的儿童进行常规补铁,前提是这些国家/地区已经采取公共卫生措施来预防、诊断和治疗疟疾。[43]World Health Organization. Daily iron supplementation in infants and children. 2016. http://www.who.int/nutrition/ (last accessed 21 February 2017).http://www.who.int/nutrition/publications/micronutrients/guidelines/daily_iron_supp_childrens/en/[44]World Health Organization. Daily iron supplementation in adult women and adolescent girls. 2016. http://www.who.int/nutrition/ (last accessed 21 February 2017).http://www.who.int/nutrition/publications/micronutrients/guidelines/daily_iron_supp_womenandgirls/en/ [
]Is there randomized controlled trial evidence to support the use of oral iron supplements (with or without folic acid) in children in malaria-endemic areas?https://cochranelibrary.com/cca/doi/10.1002/cca.1350/full显示答案