Clinical trial with the levonorgestrel intrauterine system to measure changes in hemoglobin and serum ferritin among anemic women in Kenya

项目摘要/摘要 贫血症继续对资源贫乏国家的边缘化妇女造成不成比例的影响。在……里面 在非洲/东南亚，超过2.7亿育龄妇女患有贫血症。缺铁性贫血导致 占全球孕产妇死亡的18%。需要采取多管齐下的方法来降低贫血率。 以及对家庭健康的负面影响。 在每个月经周期，女性会失去14到19毫克的铁；这是贫血女性需要摄入的铁 更健康的生活。经期铁丢失与膳食摄入量之间的关系 对铁的影响，储存铁，对血液学参数的影响是复杂的，月经水平较高 失血与较低的血红蛋白值有关。 左炔诺孕酮宫内系统是一种高效的避孕产品，一般情况下 减少月经失血。在40多年的研究中，该产品不断提高 在广泛的女性人群中，血红蛋白水平和铁储存增加，尤其是对患有 月经大出血。这种产品在资源贫乏的国家并不普遍，因为价格较高 相对于其他避孕药具的成本。 作为一种潜在的缓解贫血的工具，左旋诺孕酮宫内系统从未被 经过充分测试。以前的研究从来没有关注过贫血女性，也没有使用过适当的科学方法 确定该产品是否可以通过降低血红蛋白和铁含量显著提高水平的方法 月经失血。 这项拟议研究的总体目标是让肯尼亚的贫血妇女有机会尝试 左旋诺孕酮宫内系统，并通过改进的科学方法，测量对 储存血红蛋白和铁。在这项随机试验中，比较产品将是口服避孕药 含有补铁药丸，在肯尼亚广泛使用。如果左旋诺孕酮 宫内系统被发现如假设的那样工作，那么该产品可以成为另一种缓解 育龄妇女中的贫血，导致更健康的生活和更健康的怀孕初期 在需要的时候。

PROJECT SUMMARY/ABSTRACT Anemia continues to disproportionately affect marginalized women in resource-poor countries. In Africa/SE Asia, over 270 million women of reproductive age are anemic. Iron deficiency anemia causes 18% of maternal deaths worldwide. Multiprong approaches are needed to reduce the prevalence of anemia and the negative impact on family health. Every menstrual cycle, women lose 14 to 19 mg of iron; this is iron that anemic women need to lead healthier lives. Though the relationships between iron loss from menstruation, absorption of dietary intake of iron, storing iron, and the impacts on hematologic parameters are complex, higher levels of menstrual blood loss are associated with lower hemoglobin values. The levonorgestrel intrauterine system is a highly effective contraceptive product that also generally reduces menstrual blood loss. In research spanning over four decades, the product consistently raises hemoglobin levels and increases iron stores in broad populations of women, but particularly for women with heavy menstrual bleeding. This product is not widely available in resource-poor countries, due to higher costs relative to other contraceptives. As a potential tool to alleviate anemia, the levonorgestrel intrauterine system has never been adequately tested. Previous research has never focused on anemic women, nor used proper scientific approaches to determine if the product can significantly increase hemoglobin and iron levels via reducing menstrual blood loss. The overall goal of the proposed research is to give anemic women in Kenya an opportunity to try the levonorgestrel intrauterine system and with improved scientific approaches, measure the impact on hemoglobin and iron stores. In this randomized trial, the comparison product will be oral contraceptives containing iron supplement pills, which are widely available and used in Kenya. If the levonorgestrel intrauterine system is found to work as hypothesized, then the product can become another tool to alleviate anemia among reproductive-aged women, resulting in healthier living and healthier beginnings to pregnancy when desired.