Comparison of Ferric Carboxymaltose Versus Iron Sucrose for Treatment of Iron Deficiency Anaemia in Pregnant Women

Abstract

Objective: To compare the mean rise in hemoglobin with ferric carboxymaltose versus iron sucrose for treating iron deficiency anaemia in pregnant women

Methodology:  This randomized controlled trial study was conducted at Department of Obstetrics & Gynaecology, Combined Military Hospital Multan from February 2024 to July 2024. Sixty pregnant women (20-45 years, 28-34 weeks gestation) with iron deficiency anemia (Hb <10 gm%, ferritin <30 ng/ml) were randomized via lottery method to intravenous ferrous carboxymaltose (FCM; 1000 mg/sitting) or iron sucrose complex (ISC; 300 mg twice weekly). Both groups received anthelminthic therapy and folic acid. Total iron dose was calculated as (2.4×weight×Hb deficit) +500 mg. Hemoglobin, ferritin, and demographics were recorded. Post-treatment outcomes were assessed at 3 weeks. Descriptive statistics were run using SPSS version 23. The mean rise in hemoglobin between the groups was compared through independent t-tests at 5% significance level.

Results: Participants’ mean age was 31.4±3.9 years. Baseline Hb and ferritin were 8.8±0.5 g/dL and 31.6±12.8 ng/mL respectively. Post-treatment, FCM demonstrated higher mean Hb (10.7±0.4 vs.10.4±0.3 g/dL), ferritin (370.9±47.6 vs.261.1±34.2 ng/mL), and Hb rise (2.0±0.3 vs.1.4±0.2 g/dL) compared to ISC (p<0.001). Educational status, socioeconomic class, and baseline Hb differed significantly between groups. Stratified analysis confirmed sustained superiority of FCM across demographics (p<0.001).

Conclusion: Intravenous ferrous carboxymaltose outperformed iron sucrose in correcting haemoglobin and levels of ferritin in iron-deficient pregnant women, despite baseline disparities. FCM offers a more efficacious parenteral iron therapy option in this population.