title: Intravenous ferric carboxymaltose for anaemia in pregnancy.
abstract: BACKGROUND
  Iron deficiency is a common nutritional deficiency amongst women of childbearing age. Peri-partum iron deficiency anaemia (IDA) is associated with significant maternal, fetal and infant morbidity. Current options for treatment are limited: these include oral iron supplementation, which can be ineffective and poorly tolerated, and red blood cell transfusions, which carry an inherent risk and should be avoided. Ferric carboxymaltose is a new treatment option that may be better tolerated.The study was designed to assess the safety and efficacy of iron deficiency anaemia (IDA) correction with intravenous ferric carboxymaltose in pregnant women with mild, moderate and severe anaemia in the second and third trimester.
  
  
  METHODS
  Prospective observational study; 65 anaemic pregnant women received ferric carboxymaltose up to 15 mg/kg between 24 and 40 weeks of pregnancy (median 35 weeks gestational age, SD 3.6). Treatment effectiveness was assessed by repeat haemoglobin (Hb) measurements and patient report of well-being in the postpartum period. Safety was assessed by analysis of adverse drug reactions and fetal heart rate monitoring during the infusion.
  
  
  RESULTS
  Intravenous ferric carboxymaltose infusion significantly increased Hb values (p < 0.01) above baseline levels in all women. Increased Hb values were observed at 3 and 6 weeks post infusion and up to 8 weeks post-infusion. Ferritin values increased significantly after the infusion. Only 4 women had repeat ferritin values post-partum which remained above baseline levels. Fetal heart rate monitoring did not indicate a drug related negative impact on the fetus. Of the 29 (44.6%) women interviewed, 19 (65.5%) women reported an improvement in their well-being and 9 (31%) felt no different after the infusion. None of the women felt worse. No serious adverse effects were found and minor side effects occurred in 13 (20%) patients.
  
  
  CONCLUSIONS
  Our prospective data is consistent with existing observational reports of the safe and effective use of ferric carboxymaltose in the treatment of iron deficiency anaemia in pregnancy.
authors.affiliation: Department of Anaesthesia, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale 5112, South Australia, Australia. bernd.froessler@health.sa.gov.au.
authors.forename: Bernd
authors.initials: B
authors.lastname: Froessler
authors.forename: Joshua
authors.initials: J
authors.lastname: Collingwood
authors.forename: Nicolette A
authors.initials: NA
authors.lastname: Hodyl
authors.forename: Gustaaf
authors.initials: G
authors.lastname: Dekker
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005865:Gestational Age; D006454:Hemoglobins; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007501:Iron / Q000097:blood*; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005290:Ferric Compounds; D006454:Hemoglobins; C522335:ferric carboxymaltose; D008320:Maltose; D007501:Iron