Effect of intravenous iron sucrose on hemoglobin level, when administered in a standard-dose, to anemic pregnant women in rural Northern India

Abstract

Introduction:To combat anemia among pregnant women, in Haryana, Northern India, administration of intravenous iron sucrose (IVIS) was initiated in 2014 as a public-health measure. We assessed the effect of IVIS on hemoglobin (Hb) levels among the pregnant anemic women.Methods:Pregnant women identified as moderately or severely anemic (Hb <10.0 g/dL) in the second or third trimester during routine antenatal care were prescribed IVIS in a standard-dose of 400 mg given as 100 mg on alternate days. Neither dose calculation, nor allowance for iron-store, was included in this study. We analyzed the data collected between June 2014 and December 2015, at the two primary-health-centers, on Hb level (by HemoCue method) before start of the therapy (baseline), and 4-week or more after the last infusion (endline).Results:A total of 990 women received IVIS. Both baseline and endline Hg-levels were available for 763 (77%), who were included in the analysis. At baseline, the proportion of moderate and severe anemia was 87.94% and 12.06%, respectively. Mean (standard deviation)-Hb increased from 7.85 g/dL (0.80) at baseline, to 9.62 g/dL (1.30) at endline, with a mean increase of 1.76 g/dL (95% confidence interval 1.67, 1.85). The mean increase in Hb-level for pregnant women who had severe and moderate anemia at baseline was 2.54 g/dL and 1.65 g/dL, respectively. Overall, 15.33% of women achieved normal Hb-level by the time of endline measurement. No serious adverse reactions were reported during the observation period.Conclusion:Mean increase in Hb-level was 1.76 mg/dL. Severely anemic pregnant women had larger increase in Hb-level when compared with pregnant women with moderate anemia.

The study of efficacy of injection iron sucrose in treatment of iron deficiency anemia in pregnancy

“…They recommended that dose of iron sucrose should be calculated as per Ganzoni's formula and dose be given accordingly as was done in this study. 16 Present study supports the studies mentioned above and shows that iron sucrose is well tolerated as a parenteral iron preparation and has good outcomes in terms of increase in hemoglobin levels 6 weeks after treatment and term with a significant rise in serum ferritin levels which is more important to cater for the anticipated blood loss during delivery and lactational requirement.…”

Study of outcome of the treatment with intravenous iron sucrose in moderately anaemic pregnant women

“…Most studies had measured Hb level when the interval between last dose of IVIS, and Hb measurement was atleast 4 weeks. 6 In our study which included 50 antenatal patients, the mean Hb before starting treatment was 8.172 g/dl and after 4 weeks of treatment was 11.066 g/dl with a p value of 0.0001 (p<0.05) which was statistically significant. The average rise in the Hb in the 4 weeks time was 2.894g/dl with a p value <0.05 which was statistically significant.…”

Effect of intravenous iron sucrose on hemoglobin level, when administered in a standard dose, to anemic pregnant women in rural Northern India

“…First, Haldar et al stated that they assessed the effect of intravenous iron sucrose (IVIS) on hemoglobin (Hb) levels among the pregnant anemic women. [ 1 ]…”

“…Other authors mentioned that the IVIS should be used for treatment of iron deficiency (ID) and iron deficiency anemia (IDA), and the diagnosis of IDA should be based the following parameters: Hb concentration (g/dl), serum ferritin (μg/l), mean corpuscular volume (MCV), and mean corpuscular Hb (MCH). [ 2 3 4 5 6 ] We think that Haldar et al [ 1 ] should include in their study women with IDA only. [ 2 3 ]…”

“…Second, Haldar et al [ 1 ] stated that pregnant women, identified as moderately or severely anemic (Hb <10.0 g/dl) in the second or third trimester during routine antenatal care, were prescribed IVIS in a standard dose of 400 mg given as 100 mg on alternate days without dose calculation or allowance for iron store was included in their study. [ 1 ]…”