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A Randomised Controlled Trial to Compare Injection Ferric Carboxymaltose and Oral Iron in Treating Iron Deficiency Anemia During Pregnancy

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Abstract

Introduction

Iron deficiency anemia (IDA) in pregnancy has a prevalence as high as 40–60% in different countries of the world. Oral iron is used to treat his commonest medical disorder in pregnancy. Ferrous sulphate is associated with considerable side effects. Ferric carboxymaltose (FCM) is a newer iron preparation which allows for single and higher dose (up to 1000 mg) of IV iron infusion. This study was conducted to compare the efficacy of FCM and FS in treating IDA during pregnancy.

Methods

A randomised control trial was done at a tertiary care centres involving 362 women (181 women each in FS and FCM group). The pregnant anemic women with IDA were enrolled between 18 and 34 weeks of pregnancy. They were given 1000 mg of FCM iv as single dose or were given FS tablets twice daily (120 mg iron daily). The data were collected for rise in the Hb and serum ferritin over a period of 6 weeks.

Results

Nine and 18 patients were lost to follow-up in the FCM and FS group, respectively. The data were analysed as per protocol analysis. FCM group women showed 2.6 gm% rise in Hb compared to 1.7 gm% of FS group. One hundred and sixty-six out of 172 women in FS group achieved anemia correction at 6 weeks. No difference was observed in the neonatal outcome. No major side effects were observed in the either group.

Conclusion

In our study, FCM was more effective than oral FS in increasing Hb in women with IDA during pregnancy. This clinical benefit with FCM was achieved without the concerns for safety and tolerability of the drug.

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Authors and Affiliations

  1. AFMC, Pune, India

    Sushil Chawla

  2. Ruby Hall Hospital, Pune, India

    Akhileshwar Singh

  3. Department of Surgery, AICTS, Pune, India

    D. Jhamb

  4. INHS Kalyani, Visakhapatnam, India

    C. H. Anupama

Authors
  1. Sushil Chawla
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  2. Akhileshwar Singh
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  3. D. Jhamb
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  4. C. H. Anupama
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Contributions

Study concept: SC and AS. Study conduct: SC, AS, AHA, and DJ. Drafting and manuscript revision: SC and AS. Statistical analysis: AS, CHA, and DJ. Study supervision: SC.

Corresponding author

Correspondence to Sushil Chawla.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional ethics committee at AFMC, Pune, and I certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Chawla, S., Singh, A., Jhamb, D. et al. A Randomised Controlled Trial to Compare Injection Ferric Carboxymaltose and Oral Iron in Treating Iron Deficiency Anemia During Pregnancy. J Obstet Gynecol India 72, 492–496 (2022). https://doi.org/10.1007/s13224-022-01653-8

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  • DOI: https://doi.org/10.1007/s13224-022-01653-8

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