The following is a summary of “A Randomised Controlled Trial to Compare Injection Ferric Carboxymaltose and Oral Iron in Treating Iron Deficiency Anemia During Pregnancy” published in December 2022 issue of Obstetrics and Gynecology by Chawla, et al.

Iron deficiency anemia (IDA) during pregnancy affects 40-60% of pregnant women worldwide. Oral iron is used to treat the most common medical problem in pregnancy. Ferrous sulphate has a number of negative side effects. Ferric carboxymaltose (FCM) is a newer iron preparation that makes it possible for a single and higher dose (up to 1,000 mg) of IV iron infusion. The purpose of this study was to compare the effectiveness of FCM and FS in treating IDA during pregnancy.

A randomised controlled trial involving 362 women was conducted at tertiary care centres (181 women each in FS and FCM groups). The pregnant anaemic women with IDA were decided to enroll between the ages of 18 and 34 weeks. They were either given 1000 mg of FCM iv as a single dose or FS tablets twice daily (120 mg iron daily). Over a 6-week period, data on Hb and serum ferritin levels were collected.

In the FCM and FS groups, respectively, nine and 18 patients were lost to follow-up. The information was examined using protocol analysis. Women in the FCM group had a Hb rise of 2.6 gm% as opposed to 1.7 gm% in the FS group. At 6 weeks, 166 out of 172 women in the FS group had their anemia corrected. The neonatal outcome showed no difference. There were no significant side effects in either group.

This study shows that injection FCM is more effective than oral ferrous sulphate in increasing Hb levels and treating iron deficiency anemia during pregnancy. FCM provided this clinical advantage without raising issues regarding the drug’s tolerability or safety.