Comparison of intravenous iron sucrose with oral iron in pregnant women with iron deficiency anaemia

Rudra, Samar; Chandna, Archana; Nath, Jayati

doi:10.18203/2320-1770.ijrcog20160577

Cited by 13 publications

(27 citation statements)

References 7 publications

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“…The majority of studies involved a comparison group of some kind including oral iron (n = 17; 36%), 11,14,16,19,24,26,27,29,31,32,34,35,37,39,50,56,57 IV iron (n = 4; 9%), 13 [14][15][16]18,20,24,26,28,31,[33][34][35][36][37][38][39]41,42,44,49,50,53 Only one study was identified that directly compared the administration of a full replacement dose of IV iron to a dose that was 300 mg less than the calculated full replacement dose. In comparing the two groups, administration of the full replacement dose was associated with a greater increase of 8 g/L 3-4 weeks after administration and 14 g/L at delivery.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…14,16,29,32,34,35,39,50,56 Two studies compared IV to IM administration, noting a higher rate of ADRs in the IM group (27% and 24%) compared with the IV group (3% and 8%).…”

Section: Tolerabilitymentioning

confidence: 99%

“…The prevalence of moderate or severe adverse reactions requiring treatment or discontinuation of IV iron was slightly higher in observational studies (13/1352; 9.6 per 1000 women; n = 20 studies) 12,13,19,20,22,23,32,33,40,41,44- [11][12][13][14][15][16]19,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][44][45][46][47][49][50][51] or FCM (1/276; 3.6 per 1000).…”

Section: 38mentioning

confidence: 99%

“…Compared to oral iron, use of IV iron was associated with a greater increase in haemoglobin at 2-4 weeks following the infusion (median: 6 g/L; range: 1-20 g/L) 11,16,26,27,29,31,34,35,37,39,50,56 and at delivery (median: 6.8 g/L; range: 6-19 g/L). 14,16,32,56 When examining ferritin at 4 weeks, seven of eight studies demonstrated a greater median increase of 38 μg/L (range: 25-222 μg/L) among the group receiving IV rather than oral therapy.…”

mentioning

confidence: 95%

“…14,16,32,56 When examining ferritin at 4 weeks, seven of eight studies demonstrated a greater median increase of 38 μg/L (range: 25-222 μg/L) among the group receiving IV rather than oral therapy. 11,24,26,27,35,37,50,56 Only two studies reported on difference in ferritin at deliv- …”

mentioning

confidence: 99%

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Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Qassim

Mol

Grivell

et al. 2017

Aust NZ J Obst Gynaeco

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Background: Intravenous (IV) iron in pregnancy is useful where oral iron is not tolerated or a rapid replenishment of iron is required. Aims:To review the literature on the efficacy and safety of different IV iron preparations in the management of antenatal iron-deficiency anaemia (IDA). Materials and methods:We searched MEDLINE, Embase and Scopus from inception to June 2016. Eligible studies were randomised controlled trials (RCTs) and observational studies, involving administration of IV iron (ferric carboxymaltose (FCM), iron polymaltose (IPM) or iron sucrose (IS)), regardless of comparator, to manage antenatal IDA. Two independent reviewers selected studies, extracted data and assessed quality.

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Section: Overview Of Included Studiesmentioning

confidence: 99%

“…14,16,29,32,34,35,39,50,56 Two studies compared IV to IM administration, noting a higher rate of ADRs in the IM group (27% and 24%) compared with the IV group (3% and 8%).…”

Section: Tolerabilitymentioning

confidence: 99%

Section: 38mentioning

confidence: 99%

mentioning

confidence: 95%

mentioning

confidence: 99%

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Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Qassim

Mol

Grivell

et al. 2017

Aust NZ J Obst Gynaeco

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Risk of Infection Associated With Administration of Intravenous Iron

et al. 2021

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IMPORTANCEIntravenous iron is recommended by many clinical guidelines based largely on its effectiveness in reducing anemia. However, the association with important safety outcomes, such as infection, remains uncertain. OBJECTIVE To examine the risk of infection associated with intravenous iron compared with oral iron or no iron. DATA SOURCES Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for randomized clinical trials (RCTs) from 1966 to January 31, 2021. Ongoing trials were sought from ClinicalTrials.gov, CENTRAL, and the World Health Organization International Clinical Trials Search Registry Platform. STUDY SELECTION Pairs of reviewers identified RCTs that compared intravenous iron with oral iron or no iron across all patient populations, excluding healthy volunteers. Nonrandomized studies published since January 1, 2007, were also included. A total of 312 full-text articles were assessed for eligibility. DATA EXTRACTION AND SYNTHESIS Data extraction and risk of bias assessments were performed according to the Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) and Cochrane recommendations, and the quality of evidence was assessed using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach. Two reviewers extracted data independently. A random-effects model was used to synthesize data from RCTs. A narrative synthesis was performed to characterize the reporting of infection. MAIN OUTCOMES AND MEASURESThe primary outcome was risk of infection. Secondary outcomes included mortality, hospital length of stay, and changes in hemoglobin and red blood cell transfusion requirements. Measures of association were reported as risk ratios (RRs) or mean differences.RESULTS A total of 154 RCTs (32 920 participants) were included in the main analysis. Intravenous iron was associated with an increased risk of infection when compared with oral iron or no iron (RR, 1.17; 95% CI, 1.04-1.31; I 2 = 37%; moderate certainty of evidence). Intravenous iron also was associated with an increase in hemoglobin (mean difference, 0.57 g/dL; 95% CI, 0.50-0.64 g/dL; I 2 = 94%) and a reduction in the risk of requiring a red blood cell transfusion (RR, 0.93; 95% CI, 0.76-0.89; I 2 = 15%) when compared with oral iron or no iron. There was no evidence of an effect on mortality or hospital length of stay. (continued) Key Points Question In patients who require treatment with intravenous iron, what is the evidence that this intervention increases the risk of developing a new infection? Findings In this systematic review and meta-analysis of 154 randomized clinical trials that included 32 920 participants, intravenous iron was associated with an increased risk of infection. Meaning The results of this study suggest that, despite broad advocacy in clinical guidelines, intravenous iron may increase the risk of infection, which must be balanced with the potential benefits of treating anemia and reducing blood transfusion requirements.

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Efficacy of iron treatments on hemoglobin and ferritin levels in iron deficient pregnant women: Systematic review and meta-analysis

Akshay Kirthan,

Somannavar,

George

2023

Clinical Epidemiology and Global Health

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Comparison of intravenous iron sucrose with oral iron in pregnant women with iron deficiency anaemia

Cited by 13 publications

References 7 publications

Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

Risk of Infection Associated With Administration of Intravenous Iron

Efficacy of iron treatments on hemoglobin and ferritin levels in iron deficient pregnant women: Systematic review and meta-analysis

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