Intravenous Versus Oral Iron for Treatment of Anemia in Pregnancy

Al, Ragip Atakan; Ünlübilgin, Eylem; Kandemir, Ömer; Yalvaç, Serdar; Cakir, Leyla; Haberal, Alı

doi:10.1097/01.aog.0000185260.82466.b4

Cited by 149 publications

(117 citation statements)

References 12 publications

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“…Both iron dextran and iron gluconate cause unpredictable anaphylactic reactions and require a test dose before the first administration. However, iron sucrose is safe and can be administered without a test dose [5]. Iron sucrose injection is an aqueous complex of polynuclear iron(III)-hydroxide in sucrose.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Intravenous Iron Sucrose in Management of Iron-Deficient Anemia of Pregnancy at Rural Hospital Set Up

Shrivastava

Inamdar

Bhute

et al. 2012

J Obstet Gynecol India

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Objectives Critical evaluation of iron sucrose (Malhotra, FOGSI Focus 9-11, 2009) in terms of efficacy, safety, and feasibility at rural setup for the treatment of anemia of pregnancy (Raja et al., Rawal Med J 28: 40-3, 2003) along with any reduction in blood transfusion rate at peripartum period of 37 weeks to 48 h within delivery. Methods In a prospective cohort study conducted in Department of Obstetrics and Gynaecology, during the year 2008 AVBRH-Wardha, 256 consecutive women of irondeficient anemia (IDA) treated with intravenous iron sucrose were studied for feasibility, safety, and efficacy of drug. Blood transfusion rates were compared for the years 2007 and 2008 in cases of antenatal women from 37 weeks onward up to 48 h post delivery. Results were analyzed by Z-test. Results Mean rises in Hb g% were 1.1 ± 0.2, 2.3 ± 0.8, and 3.0 ± 0.4 after 1, 2, and 3 weeks, respectively. Decline in rate of blood transfusion among total anemic women at peripartum period was 9.36 %.Conclusion Iron sucrose therapy is very much relevant in rural scenario.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Intravenous Iron Sucrose in Management of Iron-Deficient Anemia of Pregnancy at Rural Hospital Set Up

Shrivastava

Inamdar

Bhute

et al. 2012

J Obstet Gynecol India

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“…1). Therefore, data were extracted from the remaining 6 RCTs [16,17,18,19,20,21] and were analysed in the present systematic review. Overall, 576 pregnant women were randomly assigned to an intravenous iron sucrose group (n = 289) or an oral iron group (n = 287).…”

Section: Resultsmentioning

confidence: 99%

Intravenous Iron Sucrose versus Oral Iron in the Treatment of Pregnancy with Iron Deficiency Anaemia: A Systematic Review

Shi

Leng²,

Wazir

et al. 2015

Gynecol Obstet Invest

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Background: Intravenous iron sucrose and oral iron therapy are the main therapies for iron deficiency anaemia (IDA), but there is still a debate regarding their efficacy and especially as to which one is the best choice during pregnancy. Methods: A meta-analysis of randomised controlled trials comparing patients treated with intravenous iron sucrose (intravenous group) with those treated with oral iron (oral group) for IDA during pregnancy was performed. The primary outcomes of interest were mean maternal haemoglobin and serum ferritin levels at the end of treatment. Secondary outcomes were treatment-related adverse events and foetal birth weight. Results: Six randomised controlled trials, involving a total of 576 women, were included in the present review. Significant increases in haemoglobin [mean difference (MD), 0.85; 95% confidence interval (CI), 0.31-1.39; p = 0.002] and ferritin levels (MD, 63.32; 95% CI, 39.46-87.18; p < 0.00001) were observed in the intravenous group. Compared with the oral group, there were fewer adverse events in the intravenous group (risk ratio, 0.50; 95% CI, 0.34-0.73; p = 0.0003). There was no significant difference in birth weight between the two groups. Conclusion: For pregnant women who could not tolerate the side effects of oral treatment or required a rapid replacement of iron stores, intravenous iron sucrose was associated with fewer adverse events and was more effective than regular oral iron therapy.

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“…From these studies, 70–97% of the iron is used for erythropoiesis, with only a 4–6% elimination rate. Because of this biologic advantage, intravenous iron sucrose has been approved for the treatment of IDA in the following conditions: pregnancy [11], postpartum state [12], inflammatory bowel disease [13], malignancies [14] and chronic hemodialysis [15]. …”

Section: Discussionmentioning

confidence: 99%

“…In the group of patients where iron was administered intravenously, the dose for total iron sucrose was calculated from the following formula: weight (kg) × [target Hb (g/dl) – actual Hb (g/dl)] × 2.4 + 500 mg, and rounded up to the nearest multiple of 100 mg [11]. Target Hb was established to be 10 g/dl in our study.…”

Section: Methodsmentioning

confidence: 99%

“…In recent years, it has been reported that intravenous administration of iron could ameliorate anemia more rapidly and effectively than oral iron in the following conditions: pregnancy [11], postpartum period [12], inflammatory bowel disease [13], malignancies [14] and chronic hemodialysis [15]. Evidence pertaining to safety has also been accumulated without initial concern about anaphylactic reactions [16].…”

Section: Introductionmentioning

confidence: 99%

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Safety and Usefulness of Intravenous Iron Sucrose in the Management of Preoperative Anemia in Patients with Menorrhagia: A Phase IV, Open-Label, Prospective, Randomized Study

et al. 2009

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Background: The aim of this study was to compare the efficacy, safety and achievement of the target hemoglobin level (Hb ≥10 g/dl) in patients with preoperative anemia due to menorrhagia who received intravenous iron sucrose compared with oral iron protein succinylate for anemia management. Methods: Seventy-six patients with Hb levels <9.0 g/dl who were scheduled to undergo surgical treatment were randomized to receive either intravenous iron sucrose (based on the calculated total iron deficit divided into 2 ampoule infusions intravenously 3 times a week, beginning 3 weeks before surgery) or oral iron (80 mg/day of oral iron protein succinylate daily). Results: The intravenous iron group had higher increases in Hb (3.0 vs. 0.8 g/dl; p < 0.0001) and ferritin levels (170.1 vs. 4.1 μg/l; p < 0.0001) than the oral iron group. Achieving the target Hb was also higher in the intravenous iron group than in the oral iron group (76.7 vs. 11.5%; p < 0.0001). There were tolerable adverse events in both groups. Conclusion: Preoperative intravenous iron sucrose administration is more effective than oral iron and is as safe as oral iron therapy in the correction of preoperative anemia due to menorrhagia.

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Intravenous Versus Oral Iron for Treatment of Anemia in Pregnancy

Abstract: Intravenous iron treated iron-deficiency anemia of pregnancy and restored iron stores faster and more effectively than oral iron, with no serious adverse reactions.

Cited by 149 publications

References 12 publications

Effectiveness of Intravenous Iron Sucrose in Management of Iron-Deficient Anemia of Pregnancy at Rural Hospital Set Up

Effectiveness of Intravenous Iron Sucrose in Management of Iron-Deficient Anemia of Pregnancy at Rural Hospital Set Up

Intravenous Iron Sucrose versus Oral Iron in the Treatment of Pregnancy with Iron Deficiency Anaemia: A Systematic Review

Safety and Usefulness of Intravenous Iron Sucrose in the Management of Preoperative Anemia in Patients with Menorrhagia: A Phase IV, Open-Label, Prospective, Randomized Study

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