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.

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.

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.

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.

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.