World Journal of Anemia

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VOLUME 1 , ISSUE 2 ( April-June, 2017 ) > List of Articles

RESEARCH ARTICLE

High-dose Accelerated vs Low-dose Frequent Regime of Iron Sucrose Therapy in Antenatal and Postnatal Women with Iron Deficiency

Shaheen Anjum, Nidhi Garg, Sri Beriwal, Anjum Parvez

Citation Information : Anjum S, Garg N, Beriwal S, Parvez A. High-dose Accelerated vs Low-dose Frequent Regime of Iron Sucrose Therapy in Antenatal and Postnatal Women with Iron Deficiency. World J Anemia 2017; 1 (2):31-35.

DOI: 10.5005/jp-journals-10065-0007

License: CC BY 3.0

Published Online: 01-06-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective

To compare an accelerated high-dose (500 mg) vs low-dose (200 mg) regimen of intravenous iron sucrose in a cohort of iron-deficient anemic antenatal patients in terms of efficacy, safety, and compliance.

Materials and methods

In a prospective hospital-based study, antenatal and postnatal women with anemia attending Jawaharlal Nehru Medical College and Hospital, Aligarh, India, between December 2010 and December 2012 were enrolled. The inclusion criteria were all outpatient and admitted anemic antenatal women ≤ 36 weeks gestation and postnatal women with hemoglobin (Hb) below 10 gm/dL, or serum ferritin ≤ 30 μg/L or transferrin saturation ≤ 40% irrespective of prior oral iron therapy. Patients were excluded from the study if they were hemodynamically unstable, actively bleeding, having fever, or were nauseated or vomiting. Participants were assigned to control and study groups according to simple random sampling. Intravenous iron sucrose group I (500 mg)/group II (200 mg) was infused after test dose on alternate days for the calculated total dose in the study population. Blood and iron indices were measured at baseline and after 2 weeks of administration of last dose. The primary outcome of the study was to assess the rise in Hb and safety of high-dose intravenous iron sucrose.

Results

There was a statistically significant increase in Hb level in patients receiving either regimen, with larger mean increase in group I (2.7 ± 0.4) compared with group II (2.25 ± 6.39). Serum iron and serum ferritin also increased in both fortnightly (p < 0.001). Blood transfusion was avoided by 90.1% in severely anemic cases with Hb < 7. Hospital stay was reduced by 50% in group I.

Conclusion

The accelerated regimen of high-dose (500 mg) intravenous iron sucrose in anemic antenatal patients appears to be safe and effective in correcting anemia, restoring iron stores, and avoiding blood transfusion.

How to cite this article

Anjum S, Garg N, Beriwal S, Parvez A. High-dose Accelerated vs Low-dose Frequent Regime of Iron Sucrose Therapy in Antenatal and Postnatal Women with Iron Deficiency. World J Anemia 2017;1(2):31-35.


  1. ; Leveno, K.; Bloom, S. et al., editors. Williams obstetrics. New York: McGraw-Hill; 2010.
  2. Intravenous versus oral iron for treatment of anemia in pregnancy: a randomized trial. Obstet Gynecol 2005 Dec;106(6):1335-1340.
  3. J Pak Med Assoc 2002 Sep;52(9):392-395.
  4. Intravenous iron sucrose versus blood transfusion in the management of symptomatic post partum iron deficiency anemia. J R Med Serv 2011 Mar;18(1):15-19.
  5. Recent experience with high-dose intravenous iron administration. Kidney Int 2006 Dec;104(70): S26-S29.
  6. Safety and tolerability of high dose intravenous iron sucrose administration in CKD patients — a study from a tertiary care hospital in North India. Indian J Nephrol 2006;16:129.
  7. Intravenous iron sucrose: establishing a safe dose. Am J Kidney Dis 2001 Nov;38(5):988-991.
  8. Anemia during pregnancy and treatment with intravenous iron: Review of the literature. Eur J Obstet Gynecol Reprod Biol 2003 Sep;110(1):2-7.
  9. Intravenous iron saccharate in hemodialysis patients receiving r-HuEPO. Saudi J Kidney Dis Transplant 1994 Apr-Jun;5(2):168-172.
  10. Prolonged administration over six hours of large doses of intravenous iron saccharate (500 mg) prevents severe adverse reactions in peritoneal dialysis patients. Perit Dial Int 2002 Sep-Oct;22(5):636-637.
  11. The safety and efficacy of an accelerated iron sucrose dosing regimen in patients with chronic kidney disease. Kidney Int Suppl 2003 Nov;87:S72-S77.
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