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Type: Journal article
Title: Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: a systematic review
Author: Qassim, A.
Mol, B.
Grivell, R.
Grzeskowiak, L.
Citation: The Australian & New Zealand journal of Obstetrics & Gynaecology, 2017; 58(1):22-39
Publisher: Wiley
Issue Date: 2017
ISSN: 0004-8666
Statement of
Alaa Qassim, Ben W. Mol, Rosalie M. Grivell and Luke E. Grzeskowiak
Abstract: Background: Intravenous (IV) iron in pregnancy is useful where oral iron is not tolerated or a rapid replenishment of iron is required. Aims: To review the literature on the efficacy and safety of different IV iron prep - arations in the management of antenatal iron- deficiency anaemia (IDA). Materials and methods: We searched MEDLINE, Embase and Scopus from in - ception to June 2016. Eligible studies were randomised controlled trials (RCTs) and observational studies, involving administration of IV iron (ferric carboxymalt - ose (FCM), iron polymaltose (IPM) or iron sucrose (IS)), regardless of comparator, to manage antenatal IDA. Two independent reviewers selected studies, extracted data and assessed quality. Results: A total of 47 studies were eligible (21 RCTs and 26 observational studies), investigating IS ( n = 2635; 41 studies), FCM ( n = 276; four studies) and IPM ( n = 164; three studies). All IV preparations resulted in significant improvements in haema - tological parameters, with a median increase of 21.8 g/L at 3–4 weeks and 30.1 g/L by delivery, but there was no evidence of any associated improvements in clinical outcomes. A greater median increase in Hb was observed with a high (25 g/L; range: 20–39.6 g/L) compared with low dose (20 g/L; range: 6.2–50.3 g/L). The me - dian prevalence of adverse drug reactions for IPM (2.2%; range: 0–4.5%) was lower than FCM (5.0%; range: 0–20%) and IS (6.7%; range: 0–19.5%). Conclusion: While IV iron in pregnancy improves haematological parameters, there is an absence of evidence for improvements in important maternal or peri - natal outcomes. No single preparation of IV iron appeared to be superior, with the current IV iron preparation of choice largely determined by cost and conveni - ence around administration.
Keywords: anemia; ferric compounds/administration and dosage; iron-deficiency/drug therapy; pregnancy; treatment outcome
Rights: © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
RMID: 0030075814
DOI: 10.1111/ajo.12695
Grant ID:
Appears in Collections:Obstetrics and Gynaecology publications

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