Impact of IM iron therapy in pregnant women with moderate anaemia

Abstract

In India iron deficiency is the major factor responsible for anaemia. Earlier studies had shown that IM iron sorbitol citric acid injections with 900mg of elemental iron given to pregnant women with Hb levels between 5-7.9g/dL, raised their Hb by about 2 g/dL and did not correct anaemia in all. A study was taken up to assess the impact of 1500mg of IM iron therapy on Hb levels. Apparently healthy pregnant women (n=419) in second trimester, with Hb between 5.0- 7.9 g/dL were enrolled and given ten injections each consisting of iron sorbitol citric acid complex containing 150 mg elemental iron, and 1500 µg folic acid and 150 µg B-12. Impact of the therapy on Hb, course and outcome of pregnancy and birth weight of the offspring was recorded. In a subsample (72 women), the impact of IM iron therapy was assessed on Hb, serum iron and ferritin by comparing the values prior to and 8-12 weeks after IM iron therapy. Eighty-eight per cent of women completed all 10 injections. Following IM therapy there was a significant improvement in mean values of Hb (7.2±0.82 g/dL to 9.2 ±0.86 g/dL, P<0.0001). After IM iron therapy, mean ferritin levels rose from 12.9±12.23 µg/L to 36.2±22.84 µg/L; iron deficiency (ferritin levels < 12 µg/L) decreased from 66.7% to 8.3%. The mean birth weight of infants born to those who received IM iron therapy was 2818±292.9 g. This was significantly higher (P<0.0001) than mean birthweight (2345.4+334.2g) of infants born to women who had Hb less than 8g/dL at delivery. IM iron therapy nearly eliminated iron deficiency, improved Hb levels and birth weight. Women with persistent anaemia after IM iron therapy require investigations to find out factors responsible for anaemia.