Intravenous better than oral iron in pregnant women with anaemia
Intravenous (IV) iron is less toxic and more effective compared to oral iron, making it a potential frontline therapy for neonatal iron deficiency anaemia, suggests a recent study.
In this prospective study, 74 oral iron-intolerant, second- and third-trimester iron-deficient pregnant women were questioned for oral iron intolerance and administered IV iron (1,000 mg of low-molecular-weight iron dextran in 250 mL normal saline). The remainder was infused 15 minutes after a test dose over the balance of 1 hour.
Researchers called the participants at 1, 2 and 7 days to assess delayed reactions, and measured haemoglobin levels and iron parameters 4 weeks postinfusion or postpartum. Paired t test was used for haemoglobin and iron. Fifty-eight of 73 women who completed treatment were asked about interval growth and development of their babies.
Of the participants, 60 had paired pre- and post-treatment data. The mean pre- and posthaemoglobin concentrations were 9.7 and 10.8 g/dL (p<0.00001), transferrin saturations 11.7 and 22.6 percent (p=0.0003), and ferritins 14.5 and 126.3 ng/mL, respectively (p<0.000001). Additionally, there were six women who had minor infusion reactions, all of which were resolved.
Data for 58 infants were available, and one had stunted growth for 11 months. The rest of the offspring were normal, and none were diagnosed with iron deficiency anaemia.
“Anaemia affects up to 42 percent of gravidas,” researchers said. “Neonatal iron deficiency is associated with low birth weight, delayed growth and development, and increased cognitive and behavioural abnormalities.”