Ferric Carboxymaltose as an Effective and Safe Alternative to Iron Sucrose for Treatment of Iron Deficiency Anemia during Pregnancy

TL;DR

This study compares two iron supplements for treating anemia in pregnant women, finding that one raises hemoglobin faster while the other boosts iron stores more.

Contribution

The study provides a direct comparison of efficacy and safety of two injectable iron formulations during pregnancy.

Findings

Iron sucrose (FeS) caused a significantly higher rise in hemoglobin after 14 days compared to ferric carboxymaltose (FCM).

Ferric carboxymaltose (FCM) resulted in a significantly greater increase in serum ferritin levels compared to FeS.

No significant adverse effects were observed in either treatment group.

Abstract

This was a prospective observational study to compare efficacy and safety of iron sucrose (FeS) and ferric carboxymaltose (FCM) in pregnancy conducted over 18 months at a tertiary hospital.

Pregnant women between 14 to 36 weeks gestation with moderate to severe iron deficiency anemia were enrolled in the study. The primary outcome was a rise in haemoglobin after 14 and 28 days. Change in red cell indices, serum iron studies, symptomatic improvement, adverse effects, and neonatal outcomes were also compared.

95 pregnant women with anemia were included in the study. Mean rise in haemoglobin after 14 days was significantly higher in the FeS group than in the FCM group (2.25 ± 0.91 g/dL vs. 1.69 ± 0.98 g/dL, p value = 0.01), but rise in median serum ferritin was significantly more in the FCM group (148.55 vs. 310.6; p < .001). No significant adverse effect was noted in any group.

Injectable iron preparation FeS results in an early rise in haemoglobin, while FCM leads to a higher rise in iron stores as seen by a rise in serum ferritin. As FCM requires fewer hospital visits, it is more convenient to the patient.