The treatment of iron-deficiency anaemia of pregnancy.

I. Background Iron deficiency anaemia is the most common nutritional deficiency in women of reproductive age[1] India has high prevalence of anaemia in pregnancy according to WHO[1]. Anaemia is a major contributor to maternal mortality. The effects of iron deficiency anaemia in pregnancy during antenatal, intrapartum and postnatal period are very much significant. These women suffer from fatigue, cardio respiratory problems, risk of haemorrhage, infections and even death. [2] The fetus of the iron deficient woman also may not be spared and is at risk of preterm PROM, intrauterine growth restriction, stillbirth, low birth weight, and even poor growth trajectory after birth. Dietary deficiency of of iron and folic acid along with poor bioavailability of iron is responsible for high prevalence of anemia in pregnancy. Various iron preparations are available for treatment of iron deficiency anemia. Intravenous iron preparations like iron dextran, iron sucrose and ferric carboxymaltose are available for treatment of IDA. Iron dextran has commonly been associated with allergic reactions. Iron sucrose requires multiple intravenous infusions to achieve the target hemoglobin concentration. Ferric carboxymaltose is a novel compound of polynuclear iron(III) hydroxide complexed to carboxymaltose which can be given in a single maximum dose of 1000mg infusion and thus avoids multiple infusions. Very few comparative studies have been done comparing the second generation i.v. ironsucrose therapy with the third generation i.v. FCM therapy regarding efficacy and safety profile of these drugs in pregnancy. The result would definitely help us in deciding the better of the two drugs in the treatment of iron deficiency anemia in pregnancy after weighing all the pros and cons.