Iron Sucrose infusion in Pregnancy: a comparative study
Keywords:
Iron deficiency anemia, Pregnancy, Iron sucrose, Infusion, Hemoglobin,
Abstract
Background: The most common cause of anemia in pregnancy is iron deficiency. Iron deficiency anemia (IDA) is the most common nutritional deficiency disorder in pregnant women. According to WHO, the average prevalence of IDA in pregnant women is estimated to be about 18 % in developed countries, 35-75 % (average 56%) in developing countries and 33-89% in India.Objective: A retrospective study was conducted in pregnant women with IDA attending hospital in north India to evaluate the effectiveness and safety of iron sucrose infusion in terms of improvement in Hemoglobin (Hb) status.Methods: Data of one year from July 2013 to June 2014 obtained from antenatal unit of our hospital, a community based non-profit health care facility of 350 beds with ambulatory and in patient services. All patients who diagnosed IDA, received iron sucrose as infusion with the aim to correct the iron deficiency as well as to replenish the iron stores.Result: During the study period, a total of 445 pregnant women received iron sucrose infusion, out of which 23 fulfilled the inclusion criteria and were included in the study. At the beginning, mean Hb was 7.3 ± 0.67 g/dl (range 6.2-8.7 g/dl). After completion of total iron infusion therapy, mean Hb raised to 10.80 ± 0.58 g/dl (range 9.4-11.9 g/dl). The differences in Hb value were statistically significant (p <0.001).Conclusion: We concluded that iron sucrose infusion is safe, well tolerated and effective during pregnancy.References
1. Dutta DC. Anaemia in pregnancy. Text book of obstetrics including perinatology & contraception, 6th ed. Calcutta: New Central Book Agency (P) Ltd.; 2004;262-7.
2. Kriplani A, Mahey R, Dash BB, Kulshreshta V, Agarwal N, Bhatla N. Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy. Indian J Med Res. 2013:138;78-82
3. World Health Organization. United Nations Children's Fund UNU. Iron deficiency anemia; Assessment, Prevention and Control; A guide for programme managers. World Health Organization, Geneva, 2001.
4. Geneva WHO 1DWNM 922. The Prevalence of Anemia in women.WHO1992;1-99.
5. Letsky EA. Anemia. In: James DK, Steer PJ, Weiner CP, Gonik B, editors. High Risk Pregnancy –Management Options, 2nd ed. London: WB Saunders; 1999;729-47.
6. Lone FW, Qureshi RN, Emmanuel F. Maternal anemia and its impact on perinatal outcome in a tertiary care hospital in Pakistan. Eastern Mediterr Health J. 2004;10:801-7.
7. Van Wyck DB, Martens MG, Seid MH, Baker JB, Mangione A. Intravenous ferric carboxymaltose compared with oral iron in the treatment of postpartum anemia: a randomized controlled trial. Obstet Gynecol. 2007;110:267–78.
8. Breymann C. Iron deficiency and anemia in pregnancy: Modern aspects of diagnosis and therapy. Blood Cells Mol Dis 2002; 29: 506-16.
9. Breymann C; Anemia working group. Current aspects of diagnosis and therapy of iron deficiency anemia in pregnancy. Schweiz Rundsch Med Prax 2001; 90: 1283-91.
10. Toteja GS, Singh P. Micronutrient profile of Indian population. New Delhi: Indian Council of Medical Research; 2004.
11. Hallberg L, Bjorn-Rassmussen E. Determination of iron absorption from whole diet. A new tool model using two radiation isotopes given as haem and non-haem iron. Scand J Haematol. 1972;9: 193-7.
12. Sharma JB. editor. Medical complications in pregnancy. The Obstetric Protocol, 1st ed. Delhi: Jaypee Brothers; 1998;78-98.
13. Bayoumeu F, Subiran-Buisset C, Baka NE, Legagneur H, Monnier-Barbarino P, Laxenaire MC. Iron therapy in iron deficiency anemia in pregnancy: Intravenous route verses oral route. Am J Obstet Gynecol 2002; 186: 518-22.
14. Perewusny KG, Huck R, Huck A, Breymann C. Parenteral iron-sucrose complex. Br J Nutr 2002; 88: 3-10.
15. al-Momen AK, al-Meshari A, al-Nuaim L, Saddique A, Abutalib Z, Khashogi T, et al. Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy. Eur J Obstet Gynecol Reprod Biol 1996; 69: 121-4.
16. Christoph P, Schuller C, Studer H, Irion O, Martinez B, De Tejada et al. Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose. J. Perinat. Med. 2012;40:469–74
17. Dalal M, Ranjan R, Seth S. Comparison of Oral and Intravenous Iron for Treatment ofIron Deficiency Anaemia in Pregnancy. Indian Medical Gazette 2012:9; 372-75
18. Kalaivani K. Prevalence & consequences of anaemia in pregnancy. Indian J Med Res. 2009;130:627-33
19. Milman N. Prepartumanaemia: prevention and treatment. Ann Hematol. 2008;87:949 – 59.
20. Beshara S, Lundqvist H, Sundin J, Lubberink M, Tolmachev V, Valid S, et al. Pharmacokinetic and red cell utilization of iron (III) hydroxide –sucrose complex in anemic patients: a study using positron emission tomography. Br J Haematol 1999;104:296-302.
21. Dubey S, Suri V, Aggarawal N, Das R. Is it safe to use intravenous iron sucrose during pregnancy? A randomized controlled trial. Int J ReprodContraceptObstetGynecol 2013;2:544-9.
22. Silverstein1 SB, Rodgers GM. Parenteral Iron Therapy Options. American Journal of Hematology 2004; 76:74–8.
2. Kriplani A, Mahey R, Dash BB, Kulshreshta V, Agarwal N, Bhatla N. Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy. Indian J Med Res. 2013:138;78-82
3. World Health Organization. United Nations Children's Fund UNU. Iron deficiency anemia; Assessment, Prevention and Control; A guide for programme managers. World Health Organization, Geneva, 2001.
4. Geneva WHO 1DWNM 922. The Prevalence of Anemia in women.WHO1992;1-99.
5. Letsky EA. Anemia. In: James DK, Steer PJ, Weiner CP, Gonik B, editors. High Risk Pregnancy –Management Options, 2nd ed. London: WB Saunders; 1999;729-47.
6. Lone FW, Qureshi RN, Emmanuel F. Maternal anemia and its impact on perinatal outcome in a tertiary care hospital in Pakistan. Eastern Mediterr Health J. 2004;10:801-7.
7. Van Wyck DB, Martens MG, Seid MH, Baker JB, Mangione A. Intravenous ferric carboxymaltose compared with oral iron in the treatment of postpartum anemia: a randomized controlled trial. Obstet Gynecol. 2007;110:267–78.
8. Breymann C. Iron deficiency and anemia in pregnancy: Modern aspects of diagnosis and therapy. Blood Cells Mol Dis 2002; 29: 506-16.
9. Breymann C; Anemia working group. Current aspects of diagnosis and therapy of iron deficiency anemia in pregnancy. Schweiz Rundsch Med Prax 2001; 90: 1283-91.
10. Toteja GS, Singh P. Micronutrient profile of Indian population. New Delhi: Indian Council of Medical Research; 2004.
11. Hallberg L, Bjorn-Rassmussen E. Determination of iron absorption from whole diet. A new tool model using two radiation isotopes given as haem and non-haem iron. Scand J Haematol. 1972;9: 193-7.
12. Sharma JB. editor. Medical complications in pregnancy. The Obstetric Protocol, 1st ed. Delhi: Jaypee Brothers; 1998;78-98.
13. Bayoumeu F, Subiran-Buisset C, Baka NE, Legagneur H, Monnier-Barbarino P, Laxenaire MC. Iron therapy in iron deficiency anemia in pregnancy: Intravenous route verses oral route. Am J Obstet Gynecol 2002; 186: 518-22.
14. Perewusny KG, Huck R, Huck A, Breymann C. Parenteral iron-sucrose complex. Br J Nutr 2002; 88: 3-10.
15. al-Momen AK, al-Meshari A, al-Nuaim L, Saddique A, Abutalib Z, Khashogi T, et al. Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy. Eur J Obstet Gynecol Reprod Biol 1996; 69: 121-4.
16. Christoph P, Schuller C, Studer H, Irion O, Martinez B, De Tejada et al. Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose. J. Perinat. Med. 2012;40:469–74
17. Dalal M, Ranjan R, Seth S. Comparison of Oral and Intravenous Iron for Treatment ofIron Deficiency Anaemia in Pregnancy. Indian Medical Gazette 2012:9; 372-75
18. Kalaivani K. Prevalence & consequences of anaemia in pregnancy. Indian J Med Res. 2009;130:627-33
19. Milman N. Prepartumanaemia: prevention and treatment. Ann Hematol. 2008;87:949 – 59.
20. Beshara S, Lundqvist H, Sundin J, Lubberink M, Tolmachev V, Valid S, et al. Pharmacokinetic and red cell utilization of iron (III) hydroxide –sucrose complex in anemic patients: a study using positron emission tomography. Br J Haematol 1999;104:296-302.
21. Dubey S, Suri V, Aggarawal N, Das R. Is it safe to use intravenous iron sucrose during pregnancy? A randomized controlled trial. Int J ReprodContraceptObstetGynecol 2013;2:544-9.
22. Silverstein1 SB, Rodgers GM. Parenteral Iron Therapy Options. American Journal of Hematology 2004; 76:74–8.
Published
2014-09-04
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).