W414 COMPARATIVE STUDY OF INTRAVENOUS IRON SUCCROSE AND ORAL IRON THERAPY IN IRON DEFICIENCY ANAEMIA OF PREGNANCY IN A RURAL HOSPITAL IN INDIA

Nutritional iron-deficiency anaemia (IDA) is the most common disorder in the world, affecting more than two billion people. The World Health Organization’s global database on anaemia has estimated a prevalence of 14% based on a regression-based analysis. Recent data show that the prevalence of IDA in pregnant women in industrialized countries is 17.4% while the incidence of IDA in developing countries increases significantly up to 56%. Although oral iron supplementation is widely used for the treatment of IDA, not all patients respond adequately to oral iron therapy. This is due to several factors including the side effects of oral iron which lead to poor compliance and lack of efficacy. The side effects, predominantly gastrointestinal discomfort, occur in a large cohort of patients taking oral iron preparations. Previously, the use of intravenous iron had been associated with undesirable and sometimes serious side effects and therefore was underutilised. However, in recent years, new type II and III iron complexes have been developed, which offer better compliance and toleration as well as high efficacy with a good safety profile. In summary, intravenous iron can be used safely for a rapid repletion of iron stores and correction of anaemia during and after pregnancy.

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Efficacy of oral iron therapy in geophagic women with iron deficiency anaemia residing in Botshabelo, South Africa

Journal of Medical Laboratory Science & Technology of South Africa ◽

10.36303/jmlstsa.2020.2.1.38 ◽

2020 ◽

pp. 13-21 ◽

Cited By ~ 1

Author(s):

LF Mogongoa

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Iron Absorption ◽

Binding Capacity ◽

Transferrin Saturation ◽

Oral Iron ◽

Iron Therapy ◽

Deficiency Anaemia ◽

Oral Iron Therapy ◽

Soil Consumption

Background: Iron deficiency anaemia is the most commonly encountered form of anaemia in females worldwide. This form of anaemia is, amongst others, associated with geophagia that is defined as the consumption of soil. The two main reasons for the association of geophagia with anaemia are that soil is thought to supplement mineral deficiency and geophagia is seen as a symptom of the anaemia. However, it is hypothesised that soil consumption interferes with iron absorption instead of supplementing it. The first line of therapy for iron deficiency anaemia is oral iron. Therefore, if soil consumption interferes with iron absorption it could interfere with oral iron therapy leading to patients being burdened with symptoms of anaemia as treatment is not effective. The aim of the study was to evaluate the efficacy of oral iron therapy in female participants afflicted with iron deficiency anaemia associated with geophagia. Methods: In this prospective randomised intervention study, 84 geophagic women with iron deficiency anaemia were divided into two groups. One group continued with soil consumption while the other stopped consumption. Oral iron therapy was administered for ten weeks at increasing therapy doses for both groups. Red cell and iron study parameters were evaluated at different time intervals to ascertain the efficacy of iron replacement therapy. Results: The group that stopped soil consumption showed a statistically significant change in haemoglobin (9.4 to 10.0 g/dL, p = 0.029), mean corpuscular volume (73.6 to 75.7 fl), mean corpuscular haemoglobin (23.7 to 24.6 pg), serum iron (22.5 to 28 μg/dL, p < 0.001, transferrin saturation (4.8 to 6.9%, p < 0.001) and total iron-binding capacity (467 to 441 μg/L, p = 0.001). These findings were contrary to the group that continued with consumption, where the statistical changes were only observed for the iron study parameters (serum iron: 21 to 28 μg/dL, p = 0.038; transferrin saturation: 4.3 to 6.9%, p = 0.011; total iron-binding capacity: 496 to 421 μg/L, p = 0.002). Nevertheless, the changes for both groups were clinically insignificant. Oral iron therapy did not correct the anaemia in geophagic females of both groups, this could be explained by two hypotheses where soil affected the gastrointestinal lining and soil directly interfered with therapy iron absorption. This is evidenced by the group that continued with consumption showing fewer changes than the group that abstained from soil consumption. These results were consistent with a case study where oral iron therapy was implemented. Conclusion: Oral iron therapy was not effective in geophagia cases of iron deficiency anaemia.

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A study of efficacy of oral iron and intravenous iron sucrose in the treatment of moderate anemia in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192163 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2221

Author(s):

Saloni M. Prajapati ◽

Meha K. Patel

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Oral Iron ◽

Iron Sucrose ◽

Iron Therapy ◽

Deficiency Anemia ◽

Deficiency Anaemia ◽

Blood Indices ◽

In Pregnancy

Background: Iron deficiency anaemia in pregnancy is a common medical problem throughout India with the burden of disease impacting on both mother and the newborn. It is also responsible for increased incidence of premature births, low birth weight babies and high perinatal mortality. Intravenous iron sucrose and oral iron therapy are the primary therapeutic modalities for management of iron deficiency anaemia during pregnancy, but its efficacy during pregnancy is still a matter of argument among healthcare personnel. Therefore the objective of this study is to compare the effect of oral iron and intravenous iron sucrose on hemoglobin and other blood indices among pregnant females with iron deficiency anemia.Methods: Randomized clinical trial was conducted among 400 females between 20 to 34 weeks gestation with iron deficiency anemia who were managed either with oral ferrous sulphate or intravenous iron sucrose therapy. Z test was used for statistical analysis for significance with 95% confidence interval. The hemoglobin and blood indices levels before and after initiating treatment in both groups were compared.Results: Intravenous and oral; both the treatments were associated with increment in hemoglobin but this rise was significantly more in the intravenous group than in oral. Comparing participants with low pretreatment hemoglobin among both groups, participants in the intravenous group were better benefited than oral due to respective treatment.Conclusions: Intravenous iron therapy is much effective in correcting iron deficiency anemia in pregnancy than oral iron therapy. It restores iron stores more promptly. Also intravenous iron is better tolerated compared to oral iron.

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COMPARATIVE STUDY OF INTRAVENOUS IRON SUCROSE AND ORAL IRON IN IRON DEFICIENCY ANAEMIA AMONG PREGNANT WOMEN IN RURAL

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/326 ◽

2013 ◽

Vol 2 (7) ◽

pp. 695-701 ◽

Cited By ~ 1

Author(s):

Meenal C ◽

Hiremath P.B ◽

Nidhi Bansal ◽

Thirunaaukarasu Thirunaaukarasu ◽

Srikanth S ◽

...

Keyword(s):

Iron Deficiency ◽

Comparative Study ◽

Pregnant Women ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Oral Iron ◽

Iron Sucrose ◽

Deficiency Anaemia

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Can oral iron tablets be replaced by the intravenous iron sucrose in antenatal period? A new thought.

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183298 ◽

2018 ◽

Vol 7 (8) ◽

pp. 3103

Author(s):

Snehal S. Tate ◽

Arti S. Shirsath ◽

Neelesh S. Risbud

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Oral Iron ◽

Iron Sucrose ◽

Iron Therapy ◽

Deficiency Anaemia ◽

Significant Difference ◽

Oral Group ◽

Intravenous Iron Therapy

Background: Anaemia is the commonest medical disorder that contributes significantly to maternal morbidity and mortality, preterm delivery, intrauterine growth restriction. Pregnant women are particularly vulnerable to anaemia because they have dual iron requirements both for their growth and growth of foetus. A high proportion of women in both industrialized and developing countries become anaemic during pregnancy. Intravenous iron therapy is safe convenient and effective than oral iron therapy in prevention of iron deficiency anaemia when compliance is the problem. The aim of this study is to compare the efficacy, safety and acceptability of intravenous iron Vs oral iron in prevention of iron deficiency anaemia during pregnancy. The objective of the present research was to study the efficacy, safety and acceptability of oral iron (ferrous fumarate) versus intravenous iron (iron sucrose) for the prevention of iron deficiency anaemia during pregnancy.Methods: It was a prospective comparative case control study without blinding including 400 registered antenatal women in SKNMC and GH, Narhe, Pune. Results were based on collection and analysis of data from samples within study population.Results: There was no significant difference in mean haemoglobin rise between oral group and IV group but there is significant difference between mean ferritin levels between oral group and IV group. In IV group ferritin levels at 36 weeks were almost 1.8 times more than oral group. Acceptability and convenience of IV iron was significantly more than oral iron.Conclusions: Intravenous iron therapy in the form of three divided doses, one in each trimester can be safely used in the antenatal woman as an alternative to prophylactic iron tablets for prevention of iron deficiency anaemia especially in women who are non-compliant or does not tolerate oral iron tablets.

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P511. Utilisation and efficacy of oral iron therapy in patients with iron deficiency anaemia in a nationwide cohort of ulcerative colitis patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjw019.630 ◽

2016 ◽

Vol 10 (suppl 1) ◽

pp. S359.2-S360

Keyword(s):

Ulcerative Colitis ◽

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Oral Iron ◽

Iron Therapy ◽

Deficiency Anaemia ◽

Oral Iron Therapy

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A Prospective Randomised Trial of Intravenous Iron Therapy Versus Oral Iron for Iron Deficiency Anaemia in Pregnant Australian Women

Blood ◽

10.1182/blood.v110.11.3750.3750 ◽

2007 ◽

Vol 110 (11) ◽

pp. 3750-3750 ◽

Cited By ~ 2

Author(s):

Alhossain A. Khalafallah ◽

Amanda Dennis ◽

Joan Bates ◽

Gerald Bates ◽

Lauern Smith ◽

...

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Serum Ferritin ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Oral Iron ◽

Iron Therapy ◽

Deficiency Anaemia ◽

Iv Iron ◽

Intravenous Iron Therapy

Abstract To date, limited data is available regarding prevalence of iron deficiency during pregnancy in Australia. There is little if any data currently available regarding comparative efficacy of IV iron versus oral iron therapy in pregnant women. In Australia the prevalence of iron deficiency anaemia (IDA) is approximately 5% in the general population with higher rates in pregnant women. At a single site, the Launceston General Hospital (LGH), we prospectively investigated 200 pregnant women between January and July 2007 with FBC and iron studies at the first or second antenatal visit. Among those, 40 women (20%) had iron deficiency anaemia, and were recruited to a prospective randomised trial to determine whether intravenous iron therapy (iron polymaltose) is superior to oral iron (ferrous sulphate) for the management of IDA associated with pregnancy. The patients’ median age was 28 years old (range; 19–40) with a median gestational age at recruitment of 27 weeks (range; 13–29) and a median body weight of 74 kg (range; 47–130). At recruitment median Hb was 106 g/L (range; 90–114, normal range; 120–160 g/L), while median serum ferritin was 11.5 μg/L and mean ferritin was 19 μg/L normal range; 30–460). After four weeks of treatment the Hb level increased by a mean of 6g/L on oral iron and by 10.5 g/L after IV iron. Mean/Median serum ferritin did not increase significantly in women on oral iron, but increased to a median of 96.5 μg/L and a mean of 224 μg/L in those received IV iron. Multi-variate analysis using general linear modelling for continuous variables showed a significant increase in serum ferritin after treatment with IV iron versus oral iron (p=0.017). There was no statistically significant difference in terms of Hb increment, patients’ parity, weight, and date of last pregnancy between groups. Analysis of quality of life questionnaires to assess patients’ well-being, ability to perform activities, and symptoms of anaemia showed improvement in both groups of patients with a trend to greater and faster improvement after IV iron. Both treatments were well tolerated without major side effects. The preliminary data indicate IDA is a common finding during pregnancy in the LGH population, and intravenous iron therapy appears a safe and effective treatment in this cohort of patients. This research received a grant from the Clifford Craig Medical Research Trust, Tasmania, Australia.

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