Iron isomaltoside efficient alternative to Iron Sucrose in treating postpartum anemia: Study
The most frequent haematological problem identified during pregnancy is anemia. The World Health Organization defines anemia during pregnancy as having a hemocrit of less than 33% and a hemoglobin content of less than 11 grams per milliliter.
Iron therapy is the only treatment for iron deficiency anemia, aside from the dietary changes already discussed. Government programs for the prevention and treatment of anemia use oral iron since it is a cost-efficient, safe, and effective means to replace iron. Typically, vitamin C and 180–200 mg of elemental iron are administered in two or three separate doses, spaced between meals. This study aimed to examine the safety, effectiveness, of intravenous iron isomaltoside versus intravenous Iron sucrose in the treatment of postpartum anemia.
This Randomised parallel group trial study will be done in the Department of Obstretrics and Gynaecology Shri B. M. Patil Medical College Hospital and Research Centre. All postpartum women between day 1 and day 10 of normal delivery or cesarean section with moderate anaemia (Hb 7-11 gm/dl) admitted in labor room and wards and agreeing to give written and informed consent will be included in the study. Then subjects will be randomized in to two groups in 1:1, 108 subjects in each group Group 1: One gram of intravenous iron isomaltoside was administered in a single dosage. Group 2: 200 mg, 200 mg, and 200 mg of iron sucrose were given intravenously for three days totaling 600 mg. Then the CBC and serum ferritin levels will be checked on the recruitment day followed by 21st day after therapy
The Hb increase experienced by women in the iron isomaltoside group was 1.4 gm more than that of the iron sucrose group, and this difference was statistically significant (P value<0.001). The mean size of Hb was likewise large, coming in at 2.086 mg for the iron isomaltoside group and 1.766 gm for the iron sucrose group. Both groups had an increase in serum ferritin, a measure of their iron storage.
The most prevalent type of nutritional anemia during pregnancy and the postpartum phase is iron deficiency anemia, which is a public health concern particularly in underdeveloped nations. There is a strong correlation between anemia throughout pregnancy and the postpartum phase and the morbidity of both the mother and the fetus. According to this research, iron isomaltoside is a more successful treatment for postpartum anemia than iron sucrose, and it has the added benefit of only requiring a single dose and having a lower rate of side effects and less cost compared to iron sucrose.
The result of this study indicate that iron isomaltoside causes significantly higher rise in Hb level as compared to iron sucrose. Notably, serum ferritin which a marker of iron stores increased significantly in iron isomaltoside group versus iron sucrose group which prevents recurrence of iron deficiency anemia. Side effects were minor and comparable both groups. Iron isomaltoside has an additional advantage of single doseadministration as compared to multiple doses required in iron sucrose administration.
Source: Bhosle et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(2):272–277
