Three-year follow-up of a randomised clinical trial of intravenous versus oral iron for anaemia in pregnancy

Abstract

BackgroundTo date, there are no data available concerning the impact of iron therapy on the long-term well-being and health-related quality of life (HRQoL) in pregnancy.ObjectiveTo assess the long-term effect of iron therapy on HRQoL in pregnancy.DesignThis is a follow-up study conducted between January 2010 and January 2011 of an earlier randomised open-label clinical trial of intravenous and oral iron versus oral iron for pregnancy-related iron deficiency anaemia. We used a modified version of the SF-36 questionnaire together with the original prospective HRQoL data collected during and after pregnancy.Participants and interventionsOf the original evaluable 183 pregnant Caucasian women randomised to receive oral iron or a single intravenous iron polymaltose infusion followed by oral iron maintenance, 126 women completed the follow-up HRQoL study.MethodsThe participants were followed up 4 weeks after treatment, predelivery and postdelivery for a median period of 32 months (range, 26–42) with a well-being and HRQoL questionnaire using a modified SF-36 QoL-survey and child growth charts as set by the Australasian Paediatric Endocrine Group (APEG).ResultsPatients who received intravenous iron demonstrated significantly higher haemoglobin and serum ferritin levels (p<0.001). There were strong associations between iron status and a number of the HRQoL parameters, with improved general health (p<0.001), improved vitality (physical energy) (p<0.001), less psychological downheartedness (p=0.005), less clinical depression (p=0.003) and overall improved mental health (p<0.001). The duration of breastfeeding was longer (p=0.046) in the intravenous iron group. The babies born in both groups recorded similarly on APEG growth chart assessments.ConclusionsOur data suggest that HRQoL is improved until after pregnancy in anaemic pregnant women by repletion of their iron stores during pregnancy. About 80% of the intravenous iron group showed a maintained normal ferritin until delivery with long-term benefits. Further studies to confirm these findings are warranted.

Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review

“…(Continues) addition to improved haematological outcomes, receipt of IV iron was associated with improvements in general health (P = 0.021), improved physical energy (P = 0.016), less psychological downheartedness (P = 0.005), less clinical depression (P = 0.003), and overall improved mental health status (P < 0.001). 58 In addition, duration of breastfeeding was greater (hazard ratio (HR) for cessation: 0.70, 95% CI: 0.50-0.99; P = 0.046) among women who received IV IPM.…”

Intravenous Iron Sucrose and Oral Iron for the Treatment of Iron Deficiency Anaemia in Pregnancy

“…Ferric carboxymaltose administration in pregnant women appears to be well tolerated and has a comparable safety profile to iron sucrose but offers the advantage of a much higher iron dosage at a time reducing the need for repeated applications and increasing patients comfort. Three-year follow-up of a randomised clinical trial [18] of intravenous versus oral iron for anaemia in pregnancy showed that repletion of their iron stores during pregnancy improves health related quality of life after delivery.…”

Preoperative anemia management with intravenous iron: a systematic review

“…13,34 Therefore, despite the lack of evidence in the "surgical" population, some of the results from obstetric patients can offer insight and may be translated.…”