Compare the safety and efficacy of intravenous iron supplementation with iron sucrose to the oral supplementation with ferrous ascorbate in subjects with post-partum anemia

Authors

  • Ganesh Mhaske Department of Obstetrics and Gynecology, Smt. Kashibai Navale Medical College and General Hospital, Maharashtra, India
  • Preeti Vadehra Department of Obstetrics and Gynecology, Smt. Kashibai Navale Medical College and General Hospital, Maharashtra, India
  • Chandrakala Maran Department of Obstetrics and Gynecology K. G. Hospital and Super Specialty Hospital, Coimbatore, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193780

Keywords:

Ferrous ascorbate, Iron sucrose, Oral iron therapy, Postpartum iron deficiency anaemia, Parentral iron therapy

Abstract

Background: The post-partum period is challenging enough for most new mothers. Recovering from birth, learning to parent, and taking care of her child requires lot of energy. Having anemia in postpartum period can make this process much more difficult. According to WHO, in India incidence of anemia in postnatal mother is around 58% and according to ICMR prevalence of anemia in Tamil Nadu population 76% during pregnancy. The objective of this study was to compare the efficacy of intravenous iron supplementation with Iron sucrose to the oral supplementation with ferrous ascorbate in management of patient with post-partum anemia. To study the safety and side effects of these two preparations.

Methods: This was a prospective study conducted on 100 post-partum anemic women in KG Hospital  in Coimbatore, October 2012 to November 2013 with hemoglobin less than 10g/dl but more than 6g/dl within 24-48 hours of delivery ,after satisfying inclusion and exclusion criteria were included in the study.

Results: Mean hemoglobin of oral group was 8.49±0.75 and mean hemoglobin of IV group was 8.43±0.76; 24 hours after delivery. After treatment, that is after 4 weeks mean hemoglobin of oral group was 10.38±0.79 and mean hemoglobin of IV group was 11.20±0.71.on comparing both groups, the increase in hemoglobin in the IV groups was significant. Reticulocyte count and other parameters increased significantly after four wks of starting therapy in IV group compare to the oral group. No major side effects or anaphylactic reactions were noted during study period.

Conclusions: Intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with the oral ferrous ascorbate. Intravenous iron sucrose have shorter treatment periods, increased likelihood of compliance, a lack of gastrointestinal side effects, and rapid replenishment of iron stores, making them superior to oral ferrous ascorbate.

 

References

Beard JL, Hendricks MK, Perez EM. Maternal iron deficiency anemia affects postpartum emotions and cognition. J Nutr. 2005;135:267-72.

Perez EM, Hendricks MK, Beard JL. Mother-infant interactions and infant development are altered by maternal iron deficiency anemia. J Nutr. 2005;135:850-5.

Rienold C, Dalenius K, Smith B, Brindley P, Grummer-Strawn L. Pregnancy nutrition surveillance 2007 report. Atlanta: U.S. Department of Health and Human Services, Center for Disease Control and Prevention; 2009.

Bodnar L, Scanlon K, Freedman D. High prevalence of postpartum anaemia among low income women in the United States. J Obstet Gynecol. 2001;185:4348-53.

Beard JL, Hendricks MK, Perez EM. Maternal iron deficiency anemia affects postpartum emotions and cognition. J Nutr. 2005;135:267-72.

Henly, Anderson, Avery, Hills-Bonczyk, Potter, Duckett, Anemia and Insufficient Milk in First-Time Mothers. Birth. 1995;22(2):86-92.

Bhandal N, Russell R. Intravenous versus oral iron therapy for postpartum anemia. BJOG. 2006;doi:10. 1111/j.1471-0528. 2006.01062.

Firkin F, Perington D, Rush B. DeGruchy’s clinical hematology in clinical practice. Hypochromic anemias: Iron deficiency and Sideroblastic. eds., Publication. Fifth edition. 1989:31-60.

Silverstein SB, Rodgers G. Parenteral iron therapy options. Am J Hematol. 2004;76:74-8.

Hallak M, Sharon AS, Diukman R, Auslender R, Abramovici. Supplementing iron intravenously in pregnancy. A way to avoid blood transfusions. J Reprod Med. 1997;42(2):99-103.

Breymann C. Treatment of iron deficiency anaemia in pregnancy and postpartum with special focus on intravenous iron sucrose complex. J Med Assoc Thai. 2005;88 Suppl 2:S108-9.

Agarwal S, Gupta M, Juneja M, Jain S. Evaluation of iron sucrose for post partum anemia. Int J Basic Applied Med Sci. 2013;3(2):208-11.

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Published

2019-08-26

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Original Research Articles