In a groundbreaking study published in Lancet Global Health, researchers have found that iron given intravenously corrects iron deficiency anaemia in pregnant women faster and better than iron taken by mouth.
Researchers in a recently completed clinical trial called the Ivon Trial tested a drug to treat anemia (low iron in the blood), called ferric carboxymaltose, which is new to Nigeria and much of sub-Saharan Africa.
They compared its effectiveness with orally taken ferrous sulphate tablets, which are currently used to treat anaemia in Nigeria. They found that this new drug administered by intravenous drip works faster and better, and is as safe as iron tablets taken by mouth for the treatment of anaemia.
The study was conducted by a team of researchers from the Faculty of Medicine, University of Lagos, Nigeria, led by Professor Bosede Afolabi, in collaboration with some researchers from Bayero University, Kano and Karolinska Institute, Sweden, among others.
Anemia, importance of research results
Anemia is a common cause of poor health or death in mothers and their babies, especially in Southeast Asia and sub-Saharan Africa.
According to the World Health Organization (WHO), anemia affects 37 percent of pregnant women worldwide, but disproportionately affects 46 percent of pregnant women in Africa and 48 percent in Southeast Asia.
In Nigeria, Africa's most populous country, the prevalence of anemia during pregnancy is 56 percent and 25 to 46 percent of these women have concurrent iron deficiency.
Article page with promotion of financial support
“A considerable proportion of pregnant women in Nigeria give birth while still suffering from anemia despite taking iron pills as a preventive measure during pregnancy,” according to a press release on the study signed by UNILAG Head of Communication Unit, Adejoke Alaga-Ibraheem, to announce the research.
The statement reads in part: “Some reasons for this are that some women do not tolerate the pills due to side effects such as diarrhea, nausea or vomiting, or they forget to take the pills.
“In Nigeria, intravenous administration of iron preparations, such as iron dextran, has been associated with a high risk of serious side effects, while iron sucrose requires repeated doses. A more effective and safe alternative needs to be found to overcome these problems.”
More details
Providing details about the study, UNILAG's statement indicated that the Ivon trial involved 1,056 pregnant women, aged between 15 and 49, who were between five and seven and a half months pregnant and had anemia.
Researchers found that just one dose of ferric carboxymaltose given by drip through a vein during pregnancy caused a faster rise in blood levels after four weeks, compared with an iron tablet taken by mouth three times a day.
READ ALSO: Pregnant women with anemia face higher risk of death, report says
Iron drip also corrects low body iron levels better than iron tablets and the side effects are comparable to those of iron tablets, without any adverse effects on babies.
“These findings are reassuring because pregnant women often refuse new medications for fear of harming their babies.
“We now have evidence that implementing the use of this new iron drip (ferric carboxymaltose) in regions where many pregnant women suffer from anemia, such as Africa, will be a valuable step in reducing the proportion of pregnant women suffering from this condition and its complications,” the statement said.
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 the dropper in our setting and the results were encouraging. Pregnant women were willing to accept the dropper during pregnancy, with the support of their families.
“Health workers were ready to administer iron by drip, but identified the need for increased staffing and possibly drug subsidy,” the statement added.
He added that researchers are already in touch with Nigeria's Federal Ministry of Health to add the iron drip to the list of essential medicines.