An Observational Study on the Use of IV Iron Sucrose Among Anaemic Pregnant Women in Government Healthcare Facilities from Two States of India

  • Niveditha Devasenapathy
  • Ranjana Singh
  • Premjeeth Moodbidri
  • Himanshu Bhushan
  • Sunanda Gupta
  • Sanjay P. Zodpey
  • Sutapa B. Neogi
Original Article

Abstract

Background/Purpose of the Study

In India oral iron tablets for anaemia have been distributed through the health system since many years, but there has been no significant change in the burden of anaemia. The objective of the present study was to capture the existing practices on the use of intravenous iron sucrose (an alternative treatment for anaemia) in the public health system in two states of India (Tamil Nadu and Uttar Pradesh).

Methods

An observational study in the form of a registry was maintained for 3 months at purposively chosen public health facilities in the above-mentioned states of India. Anaemic pregnant women (n = 764) who were given intravenous iron sucrose during the antenatal or post-partum period were included in the registry. Information was collected on severity of anaemia at which intravenous iron sucrose therapy was initiated, the dose and schedule given and any adverse events noted during and immediate post-infusion period.

Results

99 % of the infusions were given as slow infusion over a mean duration of 30 min, diluted with 0.9 % sodium chloride. The mean haemoglobin level at the time of start of intravenous therapy was 8.3 gm/dl. In Uttar Pradesh, 46 % of women received only one dose of iron sucrose in contrast with 15 % in Tamil Nadu.

Conclusions

Although intravenous iron sucrose is commonly used in pregnant anaemic women, standard protocols and guidelines for its usage are lacking. These need to be formulated before scaling it up across public health facilities in India.

Keywords

Anaemia Haemoglobin Iron sucrose Oral iron Pregnancy 

References

  1. 1.
    IIPS. National Family Health Survey 2005–2006 (NFHS-3) http://mohfw.nic.in/nfhsfactsheet.htm. Accessed 1 Feb 2012.
  2. 2.
    Agarwal KN, Agarwal DK, Sharma A, et al. Prevalence of anaemia in pregnant & lactating women in India. Indian J Med Res. 2006;124:173–84.PubMedGoogle Scholar
  3. 3.
    Kalaivani K. Prevalence & consequences of anaemia in pregnancy. Indian J Med Res. 2009;130:627–33.PubMedGoogle Scholar
  4. 4.
    Sharma A, Patnaik R, Garg S. Detection & management of anaemia in pregnancy in an urban primary health care institution. Indian J Med Res. 2008;128:45–51.PubMedGoogle Scholar
  5. 5.
    Verma A. A study on maternal mortality. J Obstet Gynecol India. 2008;58:226–9.Google Scholar
  6. 6.
    Rush D. Nutrition and maternal mortality in the developing world. Am J Clin Nutr. 2000;72:212S–40S.PubMedGoogle Scholar
  7. 7.
    Rebecca JS, Mullany L, Black RE. Iron deficiency anaemia. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health risks. Geneva: WHO; 2004. p. 163–209.Google Scholar
  8. 8.
    Singh P, Toteja GS. Micronutrient profile of Indian children and women: summary of available data for iron and vitamin A. Indian Pediatr. 2003;40:477–9.PubMedGoogle Scholar
  9. 9.
    National Nutrition Monitoring Bureau (NNMB). NNMB micronutrient survey. Hyderabad: National Institute of Nutrition; 2002.Google Scholar
  10. 10.
    Kumar A. National nutritional anaemia control programme in India. Indian J Public Health. 1999;43(3–5):16.Google Scholar
  11. 11.
    Rasmussen K. Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality? J Nutr. 2001;131:590S-601S; discussion S-3S.Google Scholar
  12. 12.
    Reveiz LGG, Cuervo LG. Treatments for iron-deficiency anaemia in pregnancy. Cochrane Database Syst Rev. 2007;2: CD003094.Google Scholar
  13. 13.
    Perewusnyk G, Huch R, Huch A, et al. Parenteral iron therapy in obstetrics: 8 years experience with iron-sucrose complex. Br J Nutr. 2002;88:3–10.PubMedCrossRefGoogle Scholar
  14. 14.
    Neeru S, Nair NS, Rai L. Iron sucrose versus oral iron therapy in pregnancy anemia. Indian J Community Med. 2012;37:214–8.PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Bayoumeu F, Subiran-Buisset C, Baka NE, et al. Iron therapy in iron deficiency anemia in pregnancy: intravenous route versus oral route. Am J Obstet Gynecol. 2002;186:518–22.PubMedCrossRefGoogle Scholar
  16. 16.
    Bencaiova G, von Mandach U, Zimmermann R. Iron prophylaxis in pregnancy: intravenous route versus oral route. Eur J Obstet Gynecol Reprod Biol. 2009;144:135–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Bhandal N, Russell R. Intravenous versus oral iron therapy for postpartum anaemia. BJOG. 2006;113:1248–52.PubMedCrossRefGoogle Scholar
  18. 18.
    Dede A, Uygur D, Yilmaz B, et al. Intravenous iron sucrose complex vs. oral ferrous sulfate for postpartum iron deficiency anemia. Int J Gynaecol Obstet. 2005;90:238–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Divakar H. Iron deficiency anaemia in pregnanct women: what is preventing practitioners from using IV iron sucrose. Int J Infertlity Fetal Med. 2012;3:1–7.CrossRefGoogle Scholar
  20. 20.
    Devasenapathy N, Neogi SB, Zodpey S. Is intravenous iron sucrose the treatment of choice for pregnant anemic women? J Obstet Gynaecol Res. 2013;39:619–26.PubMedCrossRefGoogle Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2014

Authors and Affiliations

  • Niveditha Devasenapathy
    • 1
  • Ranjana Singh
    • 1
  • Premjeeth Moodbidri
    • 1
  • Himanshu Bhushan
    • 2
  • Sunanda Gupta
    • 3
  • Sanjay P. Zodpey
    • 1
  • Sutapa B. Neogi
    • 1
  1. 1.Indian Institute of Public Health, DelhiGurgaonIndia
  2. 2.Maternal HealthMinistry of Health and Family WelfareNew DelhiIndia
  3. 3.WHONew DelhiIndia

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