Professor and Head, Center for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Associate Professor, Center for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Public Health. 2020 Apr-Jun;64(2):168-172. doi: 10.4103/ijph.IJPH_85_19.
Postpartum anemia is associated with postpartum anxiety, depression, poor cognitive interaction, and delayed infant development. Oral iron is the currently recommended therapy but is associated with gastrointestinal complaints and poor compliance. Parenteral iron dextran may cause serious side effects, whereas iron sucrose requires repeated visits. Intravenous ferric carboxymaltose (FCM) is given as an infusion in a single setting, which is logistically convenient both to patients and health system. It can be particularly beneficial for postpartum women who are usually discharged from health facility 48 h after delivery.
The objectives of this study were to estimate the change in mean hemoglobin (Hb) level 6 weeks after administration of intravenous FCM and to document any adverse events following administration among postpartum women.
A prospective, interventional follow-up study was conducted from August to December 2018. One hundred eligible postpartum women with Hb level of 5-9.9 g/dl were administered a calculated dose of intravenous FCM based on Ganzoni's formula with Hb target of 12 g/dl. Hb and serum ferritin were measured at baseline and at 6 weeks after FCM infusion and compared for mean increase.
There was a significant increase in Hb and serum ferritin levels after administration of FCM. The mean (95% confidence interval) increase in the Hb and serum ferritin after 6 weeks was 4.2 (3.9-4.5) g/dl and 137.3 (113.6-161.0) ng/ml, respectively. No major adverse events were reported.
Administration of FCM was safe and effective in the treatment of moderate-to-severe anemia among postpartum women.
产后贫血与产后焦虑、抑郁、认知互动不良和婴儿发育迟缓有关。口服铁剂是目前推荐的治疗方法，但会引起胃肠道不适和依从性差。铁右旋糖酐可能会引起严重的副作用，而蔗糖铁则需要多次就诊。静脉注射的羧基麦芽糖铁（FCM）可在单次输液中给予，这对患者和医疗系统在后勤方面都非常方便。对于通常在分娩后 48 小时内出院的产后妇女来说，FCM 尤其有益。
本研究旨在评估静脉注射 FCM 给药后 6 周平均血红蛋白（Hb）水平的变化，并记录产后妇女给药后的任何不良事件。
一项前瞻性、干预性随访研究于 2018 年 8 月至 12 月进行。100 名 Hb 水平为 5-9.9 g/dl 的符合条件的产后妇女根据 Ganzoni 公式计算静脉注射 FCM 的剂量，目标 Hb 为 12 g/dl。在 FCM 输注前和输注后 6 周测量 Hb 和血清铁蛋白，并比较平均增加量。
FCM 给药后 Hb 和血清铁蛋白水平显著升高。Hb 和血清铁蛋白在给药后 6 周的平均（95%置信区间）增加量分别为 4.2（3.9-4.5）g/dl 和 137.3（113.6-161.0）ng/ml。未报告重大不良事件。
FCM 给药治疗产后妇女中至重度贫血是安全有效的。
