FERRIC CARBOXY MALTOSE IN ANAEMIA IN PREGNANCY
Abstract
BACKGROUND: Iron deficiency is the common nutritional deficiency amongst women of child bearing age. Peripartum iron deficiency anaemia is associated with significant maternal, fetal and infant morbidity. Current options include oral iron supplementation, which can be ineffective and poorly tolerated, parenteral iron preparations and red blood cell transfusions, which carry an inherent risk and should be avoided. Ferric carboxy maltose is a new treatment option that may be better tolerated. The study was designed to assess the safety, efficacy and tolerability of intravenous ferric carboxymaltose for correction of iron deficiency anaemia in antenatal or postnatal period.
METHOD: Prospective cohort study, 50 iron deficiency anaemic antenatal or postnatal women received ferric carboxy maltose. Anaemia was diagnosed based on Hb levels and iron deficiency was diagnosed based on serum ferritin levels(<30µg/l). Administration of FCM (15 mg/kg, maximum of 1000 mg) over 15 minutes was well tolerated. Treatment effectiveness was assessed by follow up hemoglobin levels after 3 weeks. Safety and tolerability was assessed by analysis of adverse drug reactions and fetal heart rate monitoring in antenatal patients during the infusion.
RESULTS: Most of the women were in the age group of 22-30 years and had moderate anaemia as per WHO guidelines. Intravenous ferric carboxy maltose infusion significantly increased mean Hb values above baseline levels in almost all women. Increased Hb values were observed at 3-8 weeks post infusion. No serious adverse effects were found.
CONCLUSIONS: Intravenous ferric carboxymaltose was safe and effective in antenatal and postnatal patients with iron deficiency anaemia. It elevates Hb level and restores iron stores faster than other IV iron injectables and oral iron.
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Kalaivani k. Prevalence and consequences of anaemia in pregnancy. Indian J Med Res. 2009; 130:627-33
Lone FW, Qureshi RN, Emmanuel F: Maternal anaemia and its impact on perinatal outcome in a tertiary care hospital in Pakistan. East Mediterr Health J. 2004, 10 (6): 801-807.PubMedGoogle Scholar
Ehrenthal DB, Chichester ML, Cole OS, Jiang X: Maternal risk factors for peripartum transfusion. J Womens Health. 2012, 21 (7): 792-797. 10.1089/jwh.2011.3248.View ArticleGoogle Scholar
Bodnar LM, Cogswell ME, McDonald T: Have we forgotten the significance of postpartum iron deficiency?. Am J Obstet Gynecol. 2005, 193 (1): 36-44. 10.1016/j.ajog.2004.12.009.View ArticlePubMedGoogle Scholar
Beard J: Recent evidence from human and animal studies regarding iron status and infant development. J Nutr. 2007, 137 (2): 524S-530S.PubMedGoogle Scholar
Perez EM, Hendricks MK, Beard JL, Murray-Kolb LE, Berg A, Tomlinson M, Irlam J, Isaacs W, Njengele T, Sive A, Vernon-Feagans L: Mother-infant interactions and infant development are altered by maternal iron deficiency anemia. J Nutr. 2005, 135 (4): 850-855.PubMedGoogle Scholar
Gautam CS, Saha L, Sekhri K, Saha PK: Iron deficiency in pregnancy and the rationality of iron supplements prescribed during pregnancy. Medscape J Med. 2008, 10 (12): 283-PubMedPubMed CentralGoogle Scholar
Milman N: Postpartum anemia II: Prevention and treatment. Ann Hematol. 2012, 91 (2): 143-154. 10.1007/s00277-011-1381-2.View ArticlePubMedGoogle Scholar
Roberts CL, Ford JB, Thompson JF, Morris JM: Population rates of haemorrhage and transfusions among obstetric patients in NSW: a short communication. Aust N Z J Obstet Gynaecol. 2009, 49 (3): 296-298. 10.1111/j.1479-828X.2009.00985.x.View ArticlePubMedGoogle Scholar
Froessler et al.: Intravenous ferric carboxymaltose for anaemia in pregnancy. BMC Pregnancy and Childbirth 2014 14:115.
Sue R. Pavord: UK guidelines on the management of iron deficiency in pregnancy. British Journal of Hematology, 2012, 156, 588-600.
Milman N, Bergholt T, Byg KE, Eriksen L, Graudal N: Iron status and iron balance during pregnancy. A critical reappraisal of iron supplementation. Acta Obstet Gynecol. 1999, 78(9):749-757.View ArticlePubMedGoogle Scholar
https://www.medicines.org.uk/emc/product/5910/smpc.
Breymann C, Honegger C, Holzgreve W, Surbek D. Diagnosis and treatment of iron-deficiency anaemia during pregnancy and postpartum. Arch Gynecol Obstet.2010; 282:577-80.
Christoph P, Schuller C, Stude RH, Irion O, De Tejada BM, Surbek D. Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose. J Perinat Med. 2012; 40(5):469-74.
Vineet M, Khushali G: Role of intravenous ferric carboxymaltose in pregnant women with iron deficiency anaemia. J Nepal Health Res Counc. 2017 May- Aug;15(36):96-9.
Gautam VP, Bansal Y, Taneja DK, Saha R. Prevalence of anaemia amongst pregnant women and its sociodemographic associates in a rural area of Delhi. Indian J Com Med. 2010;27(4):157-60.
Panghal R, Boora P. Prevalence of anaemia among pregnant women of low income group of Hisar district of Haryana. Journal of Dairying Foods and Home Science. 2010;29(2):144-7.
Charytan C, Bernardo M, Koch T, Butcher A, Morris D, Bregman DB. Intravenous FCM versus standard medical care in the treatment of iron deficiency anaemia in patients with chronic kidney disease: A randomized, activecontrolled, multicentre study. Nephrol Dial Transplant. 2013;28:953-64.
David BB, Lawrence TG. Experience with intravenous FCM in patients with iron deficiency anaemia.Ther Adv Hematol. 2014;5(2):48-60.
Evstatiev, Marteau, Iqbal T , Khalif IL, Stein J, Bokemeyer B. FERGI Study Group: A randomized controlled trial on ferric carboxy maltose for iron deficiency anaemia in inflammatory bowel disease. Gastroenterology. 2011;141(3):846-53.
Iftikhar H, Jessica B, Angelia B, Todd A, Andy H, David BB. Direct comparison of the safety and efficacy of ferric carboxymaltose versus iron dextran in patients with IDA. Anaemia. 2013; Article ID 169107.
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