Chawla Sushil, Singh Akhileshwar, Jhamb D, Anupama C H
AFMC, Pune, India.
Ruby Hall Hospital, Pune, India.
J Obstet Gynaecol India. 2022 Dec;72(6):492-496. doi: 10.1007/s13224-022-01653-8. Epub 2022 Apr 15.
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.
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.
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.
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.
妊娠缺铁性贫血(IDA)在世界不同国家的患病率高达40%-60%。口服铁剂用于治疗妊娠期最常见的这种疾病。硫酸亚铁有相当多的副作用。羧基麦芽糖铁(FCM)是一种新型铁制剂,可单次大剂量(高达1000mg)静脉输注铁剂。本研究旨在比较FCM和硫酸亚铁(FS)治疗妊娠期IDA的疗效。
在一家三级医疗中心进行了一项随机对照试验,纳入362名女性(FS组和FCM组各181名女性)。患有IDA的妊娠贫血女性在妊娠18至34周期间入组。她们接受1000mg FCM静脉单次注射,或每日两次服用FS片剂(每日120mg铁)。收集6周内血红蛋白(Hb)和血清铁蛋白升高的数据。
FCM组和FS组分别有9名和18名患者失访。数据按方案分析进行分析。FCM组女性Hb升高2.6g%,而FS组为1.7g%。FS组172名女性中有166名在6周时贫血得到纠正。两组新生儿结局无差异。两组均未观察到重大副作用。
在我们的研究中,FCM在增加妊娠期IDA女性的Hb方面比口服FS更有效。使用FCM获得了这种临床益处,且无需担心药物的安全性和耐受性。