Safety and effectiveness of intravenous iron sucrose versus standard oral iron therapy in pregnant women with moderate-to-severe anaemia in India: a multicentre, open-label, phase 3, randomised, controlled trial

Neogi, Sutapa Bandyopadhyay; Devasenapathy, Niveditha; Singh, Ranjana; Bhushan, Himanshu; Divakar, Hema; Zodpey, Sanjay; Malik, Sunita; Nanda, Smiti; Mittal, Pratima; Batra, Achla; Chauhan, Meenakshi; Yadav, Sunita; Dongre, Harsha; Saluja, Sumita; Malhotra, Vani; Gupta, Anjali; Sangwan, Roopa; Radhika, A. G.; Singh, Alpana; Bhaskaran, Sruthi; Kotru, Mrinalini; Sikka, Meera; Agarwal, Sonika; Francis, Paul S.; Mwinga, Kasonde; Baswal, Dinesh

doi:10.1016/s2214-109x(19)30427-9

Cited by 48 publications

(72 citation statements)

References 33 publications

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“…Finally, iron supplementation could be required to achieve adequate iron stores, also to prevent anaemia that is related to a higher risk of prematurity and adverse perinatal outcomes. In pregnancy, both oral and iv iron has been safely used [56]. Table 1 summarizes nutrient supplementation required in pregnant women on dialysis.…”

Section: Principles Of Nutritional Management In Pregnant Women On DImentioning

confidence: 99%

Nutritional Challenges in Pregnant Women with Renal Diseases: Relevance to Fetal Outcomes

et al. 2020

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Pregnancy in women affected by chronic kidney disease (CKD) has become more common in recent years, probably as a consequence of increased CKD prevalence and improvements in the care provided to these patients. Management of this condition requires careful attention since many clinical aspects have to be taken into consideration, including the reciprocal influence of the renal disease and pregnancy, the need for adjustment of the medical treatments and the high risk of maternal and obstetric complications. Nutrition assessment and management is a crucial step in this process, since nutritional status may affect both maternal and fetal health, with potential effects also on the future development of adult diseases in the offspring. Nevertheless, few data are available on the nutritional management of pregnant women with CKD and the main clinical indications are based on small case series or are extrapolated from the general recommendations for non-pregnant CKD patients. In this review, we discuss the main issues regarding the nutritional management of pregnant women with renal diseases, including CKD patients on conservative treatment, patients on dialysis and kidney transplant patients, focusing on their relevance on fetal outcomes and considering the peculiarities of this population and the approaches that could be implemented into clinical practice.

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Section: Principles Of Nutritional Management In Pregnant Women On DImentioning

confidence: 99%

Nutritional Challenges in Pregnant Women with Renal Diseases: Relevance to Fetal Outcomes

et al. 2020

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“…Diverse intravenous iron formulas are available, with differences in unit size, nature of the carbohydrate shell (e.g., dextran, sucrose, gluconate, maltose, sorbitol), surface charge, iron form (Fe 2+ or Fe 3+ ) and content [ 106 ]. The dose of iron to be administered through parenteral routes can be calculated based on body weight and Hb levels [ 107 ], whereas the personalization of oral therapy is often missing, probably due to the perception that the vein infusion is riskier. Indeed, most of the current evidence on safety issues comes from poorly-designed small-scale trials with short follow-ups, possibly concealing long term risks of iron overload or tissue damage, especially for patients undergoing injections with concomitant high ferritin [ 108 ].…”

Section: The Present Of Iron Medicinementioning

confidence: 99%

The Central Role of Iron in Human Nutrition: From Folk to Contemporary Medicine

et al. 2020

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Iron is a fundamental element in human history, from the dawn of civilization to contemporary days. The ancients used the metal to shape tools, to forge weapons, and even as a dietary supplement. This last indication has been handed down until today, when martial therapy is considered fundamental to correct deficiency states of anemia. The improvement of the martial status is mainly targeted with dietary supplements that often couple diverse co-factors, but other methods are available, such as parenteral preparations, dietary interventions, or real-world approaches. The oral absorption of this metal occurs in the duodenum and is highly dependent upon its oxidation state, with many absorption influencers possibly interfering with the intestinal uptake. Bone marrow and spleen represent the initial and ultimate step of iron metabolism, respectively, and the most part of body iron circulates bound to specific proteins and mainly serves to synthesize hemoglobin for new red blood cells. Whatever the martial status is, today’s knowledge about iron biochemistry allows us to embrace exceedingly personalized interventions, which however owe their success to the mythical and historical events that always accompanied this metal.

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“…37 Last, there are multiple studies on iron sucrose in pregnancy and no adverse effects to the mother or fetus have been described. 27,38 In 2 pregnant patients, iron sucrose given in 4 doses of 100 mg each 1 to 2 weeks apart successfully treated RLS symptoms. 30 Interestingly, the authors of one case report noted that iron sucrose administration prior to pregnancy may have helped prevent RLS symptoms during pregnancy.…”

Section: Iron Supplementationmentioning

confidence: 99%

Management of Restless Legs Syndrome in Pregnancy and Lactation

Kondori

Kolla

Moore

et al. 2020

J Prim Care Community Health

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Restless legs syndrome (RLS) affects about 20% of all pregnant women. RLS symptoms are usually moderate to severe in intensity during pregnancy and can result in insomnia, depression, and other adverse outcomes. Although iron deficiency has been implicated as a potential etiological factor, other mechanisms can also play a role. Nonpharmacologic methods are the primary recommended form of treatment for RLS in pregnancy and lactation. Iron supplementation may be considered when the serum ferritin is low; however, several patients are unable to tolerate iron or have severe symptoms despite oral iron replacement. Here, we describe a case of severe RLS in pregnancy and illustrate the dilemmas in diagnosis and management. We review the literature on the prevalence, diagnosis, course, possible underlying pathophysiologic mechanisms and complications of RLS in pregnancy. We describe current best evidence on the efficacy, and safety of nonpharmacologic therapies, oral and intravenous iron supplementation, as well as other medication treatments for RLS in pregnancy and lactation. We highlight gaps in the literature and provide a practical guide for the clinical management of RLS in pregnancy and during breastfeeding.

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Safety and effectiveness of intravenous iron sucrose versus standard oral iron therapy in pregnant women with moderate-to-severe anaemia in India: a multicentre, open-label, phase 3, randomised, controlled trial

Cited by 48 publications

References 33 publications

Nutritional Challenges in Pregnant Women with Renal Diseases: Relevance to Fetal Outcomes

Nutritional Challenges in Pregnant Women with Renal Diseases: Relevance to Fetal Outcomes

The Central Role of Iron in Human Nutrition: From Folk to Contemporary Medicine

Management of Restless Legs Syndrome in Pregnancy and Lactation

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