Exploring Risk Factors and Assessing the Effectiveness of Intravenous Iron Sucrose versus Oral Ferrous Fumarate for Pregnancy-Related Anemia
DOI:
https://doi.org/10.62497/IRABCS.2024.58Keywords:
Pregnancy-related anemia, Oral ferrous fumarate, Risk factors, Intravenous iron sucrose.Abstract
Background: Anemia associated to pregnancy, which is defined by low hemoglobin levels or inadequate red blood cells, is a serious worldwide health issue that affects the prognosis of both mothers and fetuses. Due to food habits, healthcare access issues, and socioeconomic differences, anemia during pregnancy is very common in Pakistan.
Objective: The aim of the study was to identify risk variables linked to anemia in expectant mothers and assess the effectiveness of intravenous iron sucrose against oral ferrous fumarate in the management of iron deficient anemia during pregnancy.
Methodology: This prospective cross-sectional study was conducted from November 2022 to October 2023 at the Department of Obstetrics and Gynecology, Liaqat Memorial Hospital, Kohat, Pakistan. 120 pregnant women made up the final cohort, which was split evenly between Group B (intravenous) and Group A (oral). Group B had intravenous iron sucrose therapy, whereas Group A got oral ferrous fumarate. Serum ferritin and hemoglobin levels were assessed during the course of the 4-week follow-up assessments. The statistical analysis was performed using SPSS version 27, which showed continuous variables as mean and standard deviation and categorical data as frequency and percentage. A P value of less than 0.05 was considered noteworthy.
Results: Group A's mean hemoglobin rose from 86.49 g/dL to 102.97 g/dL (T-Value: 4.45, P-Value: 0.017), and serum ferritin increased from 8.19 ng/ml to 56.62 ng/ml (T-Value: 11.05, P-Value: 0.029). Similarly, Group B showed significant improvements, with hemoglobin increasing from 82.87 g/dL to 118.41 g/dL (T-Value: 5.26, P-Value: 0.001) and serum ferritin surging from 9.84 ng/ml to 109.85 ng/ml (T-Value: 7.37, P-Value: 0.001). Significant risk factors identified included poor nutrition (51.67%, n=62), multi-parity (59.17%, n=71), lack of antenatal care (67.50%, n=81), and lower socio-economic status (57.50%, n=69).
Conclusion: Intravenous iron sucrose is more effective than oral ferrous fumarate in increasing maternal iron stores, with a notable advantage in terms of fewer side effects.
Downloads
References
Ogunbode O, Ogunbode O. Anaemia in pregnancy. Contemporary obstetrics and gynecology for developing countries. 2021:321-30. DOI:10.1007/978-3-030-75385-6_29.
Kuma MN, Tamiru D, Belachew T. Hemoglobin level and associated factors among pregnant women in rural Southwest Ethiopia. BioMed Research International. 2021 May 19;2021:1-1. https://doi.org/10.1155/2021/9922370.
Tan EK, Tan EL. Alterations in physiology and anatomy during pregnancy. Best practice & research Clinical obstetrics & gynaecology. 2013 Dec 1;27(6):791-802. DOI: 10.1016/j.bpobgyn.2013.08.001.
Coad J, Pedley K. Iron deficiency and iron deficiency anemia in women. Scandinavian journal of clinical and laboratory investigation. 2014 Aug 1;74(sup244):82-9.https://doi.org/10.3109/00365513.2014.936694.
Benson CS, Shah A, Stanworth SJ, Frise CJ, Spiby H, Lax SJ, Murray J, Klein AA. The effect of iron deficiency and anaemia on women’s health. Anaesthesia. 2021 Apr;76:84-95. https://doi.org/10.1111/anae.15405.
Jung J, Rahman MM, Rahman MS, Swe KT, Islam MR, Rahman MO, Akter S. Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta‐analysis. Annals of the New York Academy of Sciences. 2019 Aug;1450(1):69-82. https://doi.org/10.1111/nyas.14112.
Karami M, Chaleshgar M, Salari N, Akbari H, Mohammadi M. Global prevalence of anemia in pregnant women: a comprehensive systematic review and meta-analysis. Maternal and child health journal. 2022 Jul;26(7):1473-87. https://doi.org/10.1007/s10995-022-03450-1.
Milman N. Anemia—still a major health problem in many parts of the world!. Annals of hematology. 2011 Apr;90:369-77. https://doi.org/10.1007/s00277-010-1144-5.
Naeemullah NQ, Ijaz B, Darwesh NM, Khan Z, Ishtiaq M. Frequency and Risk Factors of Anemia Among Adult Female Population of District Swat Khyber Pakhtunkhwa Pakistan. Pakistan Journal of Medical & Health Sciences. 2022 Jun 10;16(04):988. https://doi.org/10.53350/pjmhs22164988.
Rizvi A, Bhatti Z, Das JK, Bhutta ZA. Pakistan and the millennium development goals for maternal and child health: progress and the way forward. Paediatrics and international child health. 2015 Oct 2;35(4):287-97. https://doi.org/10.1080/20469047.2015.1109257
Argaw BA, Argaw-Denboba A, Taye B, Worku A, Worku A. Major risk factors predicting anemia development during pregnancy: unmatched-case control study. J Community Med Health Educ. 2015;5(353):2161-0711. http://dx.doi.org/10.4172/2161-0711.1000353
Siddiqui FR, Usmani AQ, Shahid A, Sadiq T. Dietary intake of iron rich food and awareness on iron deficiency Anaemia among female students in Rawalpindi. Pakistan Armed Forces Medical Journal. 2013 Sep 30;63(3):300-03. https://pafmj.org/PAFMJ/article/view/2176/1882.
Kumar P, Sharma H, Sinha D. Socio-economic inequality in anaemia among men in India: a study based on cross-sectional data. BMC Public Health. 2021 Dec;21:1-2. https://doi.org/10.1186/s12889-021-11393-5.
Sunguya BF, Ge Y, Mlunde L, Mpembeni R, Leyna G, Huang J. High burden of anemia among pregnant women in Tanzania: a call to address its determinants. Nutrition journal. 2021 Dec;20(1):1-1. https://doi.org/10.1186/s12937-021-00726-0.
Aslam SK, Zaheer S, Qureshi MS, Aslam SN, Shafique K. Socio-economic disparities in use of family planning methods among Pakistani women: findings from Pakistan demographic and health surveys. PloS one. 2016 Apr 7;11(4):e0153313. https://doi.org/10.1371/journal.pone.0153313.
Yakoob MY, Bhutta ZA. Effect of routine iron supplementation with or without folic acid on anemia during pregnancy. BMC public health. 2011 Dec;11:1-0. https://doi.org/10.1186/1471-2458-11-S3-S21.
Bayoumeu F. Subiran-Buisset c, Baka NE, Legagneur H, Monnier-Barbarino P, Laxenaire MC. Iron therapy in iron deficiency anemia in pregnancy: intravenous route versus oral route. Am J Obstet Gynecol. 2002;186:518–22. https://doi.org/10.1016/S0301-2115(05)80402-6.
Al-Sardari BS, Younus SK, Al-Sardari ZS. Prevalence of anemia among pregnant women in their first antenatal care visit in Erbil City: A cross sectional study. Tikrit Journal of Pure Science. 2020 Dec 18;25(5):1-8. DOI: https://doi.org/10.25130/tjps.v25i5.283.
Sridevi V, Viswanathan S, Kumari L. Prevalence and associated risk factors of anaemia in pregnancy in a tertiary care rural hospital. Journal of Evolution of Medical and Dental Sciences. 2015 Aug 10;4(64):11209-15.
Shi Q, Leng W, Wazir R, Li J, Yao Q, Mi C, Yang J, Xing A. Intravenous iron sucrose versus oral iron in the treatment of pregnancy with iron deficiency anaemia: a systematic review. Gynecologic and obstetric investigation. 2015 Mar 25;80(3):170-8. https://doi.org/10.1159/000376577.
Gupta A, Manaktala U, Rathore AM. A randomised controlled trial to compare intravenous iron sucrose and oral iron in treatment of iron deficiency anemia in pregnancy. Indian Journal of Hematology and Blood Transfusion. 2014 Jun;30:120-5. https://doi.org/10.1007/s12288-012-0224-1.
Bhavi SB, Jaju PB. Intravenous iron sucrose v/s oral ferrous fumarate for treatment of anemia in pregnancy. A randomized controlled trial. BMC pregnancy and childbirth. 2017 Dec;17(1):1-6. https://doi.org/10.1186/s12884-017-1313-9.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2024 Rabbia Allah Rakha , Haleema Tahir, Aftab Ahmad, Muhammad Yasin (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain copyright to their work published in the IRABCS journal under the Creative Commons Attribution Non-Commercial No Derivatives License (CC BY-NC-ND 4.0).