Randomized controlled trial to compare injection ferric carboxymaltose and oral iron in reducing postpartum anemia: A multicenter, pilot study

Abstract

Introduction: Iron-deficiency anemia (IDA) in pregnancy is common due to the increase demand for iron during pregnancy and is aggravated by blood loss associated with delivery. Intravenous iron formulations offer an alternative approach in the presence of moderate and severe anemia, due to intolerance of or nonadherence to oral iron and malabsorption status, to correct and prevent IDA. Ferric carboxymaltose (FCM) is a newer dextran-free iron formulation which allows for single and higher dose (up to 1000 mg) of IV iron infusion, making it a potentially ideal candidate for the treatment of postpartum anemia (PPA). Materials and Methods: A randomized control trial was conducted at two tertiary care centers involving 800 women (400 women in oral iron group and 400 women in the injection FCM group) to compare the efficacy of each in protecting the women from anemia in the postpartum period. Results: The compliance was 100% in the FCM group as the injection was given before the patient was sent on discharge after delivery. The mean rise in the hemoglobin levels in the FCM group and oral iron group was 3.76 g% and 2.476 g%, respectively. The mean rise in the serum ferritin levels in the FCM group was 214.265 mg% as noted at the end of 6 weeks. Conclusion : Injection FCM in the dose of 1000 mg given in a single dose before discharge in postpartum women helps in reducing PPA without any significant adverse effects.