A prospective, partially randomized study of pregnancy outcomes and hematologic responses to oral and intramuscular iron treatment in moderately anemic pregnant women

Sharma, Jai Bhagwan; Jain, Shyama; Mallika, V.; Singh, Tejinder; Kumar, Ashok; Arora, Raksha; Murthy, N S

doi:10.1093/ajcn/79.1.116

Cited by 44 publications

(32 citation statements)

References 27 publications

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“…The pharmacokinetic properties of iron dextran and iron sucrose are different. Iron dextran has a half-life of 3 to 4 days whereas iron sucrose has a terminal half-life of approximately 5 to 6 h and is quickly cleared from serum and thus rapidly available for erythropoiesis [9, 14]. It is shown in studies that in renal patients with severe IDA, 70-97% of the iron is used for erythropoiesis with only 4-6% elimination [15].…”

Section: Resultsmentioning

confidence: 99%

Intravenous iron sucrose v/s oral ferrous fumarate for treatment of anemia in pregnancy. A randomized controlled trial

Bhavi

Jaju

2017

BMC Pregnancy Childbirth

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BackgroundThe objective of this study was to compare the efficacy, safety and tolerability of intravenous iron sucrose with that of oral ferrous fumarate in iron deficiency anemia during 14 to 34 weeks of pregnancy.MethodsA randomized controlled trial was performed involving 112 patients attending the antenatal clinic at Shri B.M.Patil Medical college Hospital, Bijapur from October 2011 to August 2012,with hemoglobin levels between 70-110 g/L and serum ferritin of < 15 ng/ml.In the intravenous group,200 mg of iron sucrose was administered in 100 ml 0.9% sodium chloride per day. Participants in the oral group were given 200 mg of ferrous fumarate per day. The primary outcome measures for the trial, haemoglobin and serum ferritin levels were measured after 4 weeks. Statistical significance was assessed using Student’s t-test.ResultsThe change in haemoglobin in women receiving intravenous iron was higher than with oral ferrous fumarate 22 ± 11.5 g/L vs 12 ± 9 g/L (p < 0.0001).Similarly the change of serum ferritin was significantly higher in women receiving intravenous iron compared to oral iron.55% participants in the intravenous group had an improvement in haemoglobin more than 20 g/L compared to only 11% of the oral therapy group.48% of patients in I.V group showed increase in ferritin level between 51 to 100 ng/ml in comparison to only 3.5% in oral group.Intravenous iron sucrose is an effective in correction of anemia in pregnancy or iron store depletion.ConclusionIntravenous iron sucrose is more effective than 200 mg a day ferrous fumarate in increasing maternal iron stores.Trial registrationThe trial registration number is CTRI/2016/12/007552 registered in Clinical Trial Registry India on 8/12/2016. It is a retrospectively registered trial.

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Section: Resultsmentioning

confidence: 99%

Intravenous iron sucrose v/s oral ferrous fumarate for treatment of anemia in pregnancy. A randomized controlled trial

Bhavi

Jaju

2017

BMC Pregnancy Childbirth

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“…Although we did not collect data on prenatal supplement use, the proportions of pregnant women who consumed prenatal folate and iron supplements were about 30 % and 14 %, respectively, in the first class economic conditional areas in the 2002 Chinese Health and Nutrition Survey (24) . Data from studies among women who received adequate iron supplementation during pregnancy indicate that Hb decreased in the second trimester, but increased again in the third trimester (29)(30)(31) , and that iron supplementation increased average Hb concentration among pregnant women (8,30,32) . In our study, Hb concentration declined from the first trimester to the third trimester.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anaemia among pregnant women in south-east China, 1993–2005

Jin¹,

Yeung²,

Cogswell³

et al. 2010

Public Health Nutr.

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Objective: To report the prevalence of anaemia by demographic characteristics and its secular trend over 13 years for south-east Chinese pregnant women, and to determine the focus of anaemia prevention in Chinese pregnant women. Design: Prospective study of the data on Hb concentration and other demographic information from a large-scale population-based perinatal health surveillance system in south-east China. Setting: Fourteen cities or counties in Jiangsu and Zhejiang provinces. Subjects: A total of 467 057 prenatal women who had participated in the perinatal health-care surveillance system and delivered babies from 1 January 1993 to 31 December 2005 and had a record of Hb in all three pregnancy trimesters. Results: The overall prevalence of anaemia among pregnant women was 39?6 % from 1993 to 2005. Anaemia prevalence increased from the first (29?6 %) to the second (33?0 %) and third (56?2 %) trimesters. The prevalence of anaemia was higher in villagers, in women with less education and in women with higher gravidity or parity. The prevalence of anaemia in all of the trimesters was higher in the spring, summer and autumn and lower in the winter. The prevalence decreased from 1993 to 2005, from 53?3 % to 11?4 % for the first trimester, 45?6 % to 22?8 % for the second trimester and 64?6 % to 44?6 % for the third trimester. Conclusions: The prevalence of anaemia among pregnant women in Jiangsu and Zhejiang provinces decreased substantially from 1993 to 2005. However, anaemia in the third trimester is still a severe public health problem among pregnant women in these areas.

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“…Oral iron intake is the treatment of choice, and almost all women can be treated effectively with oral preparations 21 . All pregnant women attending antenatal OPD were prescribed iron and folic acid as a positive result compared to other studies where the percentages of women prescribed iron & folic acid were -West Africa (33.33%) 22 , Germany (iron-54%) 23 , Nepal (72.8%) 24 and Pakistan study (79.4%) 25 .…”

Section: Main Findings Of the Studymentioning

confidence: 99%

Prescription Pattern of Drugs in Pregnancy: A Review

Fatima¹,

Fatima²,

Hasbeen³

et al. 2015

Int. Res. J. Pharm.

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Authors carried out a systematic review of peer-reviewed literature published from [2005][2006][2007][2008][2009][2010][2011][2012][2013][2014]. We incorporated studies assessing individual-level exposures to medicines prescribed during pregnancy. We selected only those studies conducted in India and published in English. Published drug utilization studies reveal about 22% to 69.8% overall use of prescribed drugs during pregnancy excluding vitamins and minerals. On measuring antenatal drug use, the medications with positive evidence of risk (FDA category D) ranged from 4.8% to 24.25%. Iron, folic acid and vitamin supplements were most commonly prescribed drugs globally depending on the need of the patient and their benefit ratio. Overall drug use estimates are examined, use of drugs by therapeutic categories and by potential for fetal risk is considered while updating this review. Several studies consistently reported the usage of drugs with potential risks during pregnancy. Due to such extensive use, it is essential to develop standards for assessing and reporting antenatal exposures to refine any future research in this field. The prescribing practices of Indian physicians are similar to those in developed countries.

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A prospective, partially randomized study of pregnancy outcomes and hematologic responses to oral and intramuscular iron treatment in moderately anemic pregnant women

Cited by 44 publications

References 27 publications

Intravenous iron sucrose v/s oral ferrous fumarate for treatment of anemia in pregnancy. A randomized controlled trial

Intravenous iron sucrose v/s oral ferrous fumarate for treatment of anemia in pregnancy. A randomized controlled trial

Prevalence of anaemia among pregnant women in south-east China, 1993–2005

Prescription Pattern of Drugs in Pregnancy: A Review

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