Comparative study of oral iron versus 3 doses of intravenous iron sucrose in mild to moderate anemia in 2^nd and 3^rd trimester of pregnancy

Abstract

Background: Iron deficiency anemia is the most common type of nutritional anemia in pregnancy. Oral iron is the first treatment of choice because of its safety, easy availability and low cost, but compliance is a major issue due to its gastrointestinal side effects. Injectable iron sucrose can be an alternative in treatment of anemia where compliance is an issue with oral iron. Objective: Present study was done to compare the safety and efficacy of oral iron with intravenous iron sucrose in cases of mild to moderate anemia in pregnancy. Methodology: This was a prospective, randomised, interventional, comparative study carried out at GCS Medical College, Hospital and Research centre, Ahmedabad. The sample size was 100 with 50 patients in each group of treatment (oral iron and I.V. iron sucrose). The study was carried out from September 2015 to August 2016. Patients with haemoglobin 7 to 10 g/dl gestational age 14 to 36 weeks were considered for the study. Patients were randomly divided into 2 groups, group 1 was given oral iron in the form of ferrous fumarate containing 100 mg elemental iron twice a day for 4 weeks, while patients in group 2 were given 3 doses of I.V iron sucrose 200mg in 100 ml 0.9% normal saline on alternate days. Patients were followed up at 4 and 6 weeks of treatment. Results: The rise in haemoglobin levels after 4 and 6 weeks of treatment was comparable in both the groups and showed no statistical significance. Whereas the rise in serum ferritin levels after 4 and 6 weeks of treatment was much higher in I.V iron sucrose group as compared to oral iron group and it was found to be statistically significant (P<0.0001). There were no significant side effects or allergic reactions in I.V iron sucrose group. Conclusion: Oral iron and I.V iron sucrose had similar effects on rise in haemoglobin levels but iron sucrose had more effect on serum ferritin levels, hence it replenishes iron stores better and it has lesser side effects compared to oral iron.