Iron given through vein treats anaemia faster in pregnancy – Study

In a groundbreaking study published in the Lancet Global Health, researchers have found that iron given through the vein corrects iron deficiency anaemia in pregnant women faster and better than iron taken by mouth.

The researchers in a recently concluded clinical trial, called the Ivon Trial, tested a medicine for treating anaemia (low blood level), called ferric carboxymaltose, which is new in Nigeria and most of Sub-Saharan Africa.

They compared its effectiveness with oral ferrous sulphate tablets, currently used to treat anaemia in Nigeria. They found that this new medicine given in drip through the vein works faster and better, and it is as safe as the iron tablet taken by mouth for the treatment of anaemia.

The study was carried out by a team of researchers at the College of Medicine of the University of Lagos, Nigeria, led by a professor, Bosede Afolabi, in collaboration with some researchers at Bayero University, Kano and the Karolinska Institutet, Sweden, amongst others.

Anaemia, importance of research findings

Anaemia is a common cause of ill-health or death in mothers and their babies, especially in Southeast Asia and Sub-Saharan Africa.

According to the World Health Organisation (WHO), anaemia affects 37 per cent of pregnant women globally but disproportionately affects 46 per cent of pregnant women in Africa and 48 per cent in Southeast Asia.

In Nigeria, the most populous country in Africa, the prevalence of anaemia in pregnancy is 56 per cent, and 25 to 46 per cent of these women have concurrent iron deficiency.

“The sizeable proportion of pregnant women in Nigeria proceed to give birth while still anaemic despite taking iron tablets for prevention during pregnancy,” according to a press release on the study signed by the Head of Communication Unit, UNILAG, Adejoke Alaga-Ibraheem, to announce the research.

The statement reads in part: “Some reasons for this are that some women do not tolerate the tablets because of side effects like diarrhoea, nausea, or vomiting, or they forget to take the tablets.

“Available iron preparation given through a drip in Nigeria like iron dextran has been associated with a high risk of severe side effects, while iron sucrose needs repeat dosing. There is a need for an effective and safer alternative to overcome these problems.”

More details

Giving details about the study, the UNILAG statement said that the Ivon Trial enrolled 1,056 pregnant women, aged 15 to 49 years, who were between five and seven-and-half months pregnant and had anaemia.

The researchers found that only one dose of the ferric carboxymaltose given by drip through a vein during pregnancy causes a faster rise in blood level after four weeks compared to an iron tablet taken by mouth three times every day.

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The drip iron also corrects low body iron better than iron tablets and the side effects are comparable to that with iron tablets, with no adverse effect on the babies.

“These findings are reassuring because pregnant women often reject new medicines because of fear of harm to their babies.

“We now have evidence that implementing the use of this new drip iron (ferric carboxymaltose) in regions where many pregnant women suffer anaemia like Africa, will be a valuable step towards reducing the proportion of pregnant women who suffer from this condition and its complications,” the statement noted.

Next step

According to the researchers, the Ivon Trial had a clinical trial and an implementation research component, and the cost-effectiveness analysis is currently ongoing.

“At the beginning of the trial, we assessed the acceptability of using drip iron in our environment and the results were encouraging. The pregnant women were willing to accept the drip iron during pregnancy; supported by their families.

“The healthcare workers were ready to administer drip iron but identified a need to increase staff strength and possibly medicine subsidy,” the statement further noted.

It added that the researchers are already liaising with the Federal Ministry of Health, Nigeria to add the drip iron to the essential drug list.