Bergen LALELİ KOÇ, Betül AKGÜN AKTAŞ, Osman Onur ÖZKAVAK, Atakan TANACAN, Dilek SAHİN

Comparison of the Prophylactic Use of Iron Polymaltose Complex and Ferrous Sulfate Iron Preparations in Terms of Efficacy and Side Effect Profile in Pregnant Women

Introduction: Pregnancy is a physiological process in which the need for iron increases. We aimed to compare the effectiveness and side effects of different oral iron supplements on pregnant women.. Methods: 100 pregnant women between the ages of 18-45 who used Fe+2 (ferrous sulfate) valent iron supplementation during their pregnancy were included in the study as group 1. 100 pregnant women in the same age range who used Fe+3 (iron polymaltose complex) valent iron supplementation during their pregnancy were determined as group 2. Response to anemia treatment was evaluated with the results of laboratory parameters (Hgb, Hct). The side effects of the preparations used in oral iron replacement were questioned retrospectively with a questionnaire applied to the patients. Results: 16 of 100 patients (16%) had side effects with oral iron polymaltose complex supplementation. 43 of 100 patients (43%) had side effects with oral ferrous sulfate supplementation. The overall side effect was higher in those taking oral ferrous sulfate supplementation (p<0.001). Hb and Hct values measured at 3-month periods were found to be similar between the groups (p>0.05). The most common side effect was nausea and vomiting with 12%. Conclusion: Both oral ferrous sulfate and iron polymaltose complex supplementation have similar effects on hemoglobin and hematocrit levels in pregnant women without iron deficiency anemia. However, oral ferrous sulfate supplementation causes more side effects compared to iron polymaltose complex.

Keywords:

Anemia, Pregnancy, Supplements,

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1.Anemia in Pregnancy: ACOG Practice Bulletin, Number 233. Obstet Gynecol. Aug 1 2021;138(2):e55-e64. doi:10.1097/aog.0000000000004477
2.Recommendations to prevent and control iron deficiency in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep. Apr 3 1998;47(Rr-3):1-29.
3.Rasmussen K. Is There a Causal Relationship between Iron Deficiency or Iron-Deficiency Anemia and Weight at Birth, Length of Gestation and Perinatal Mortality? J Nutr. Feb 2001;131(2s-2):590S-601S; discussion 601S-603S. doi:10.1093/jn/131.2.590S
4.Tolkien Z, Stecher L, Mander AP, Pereira DI, Powell JJ. Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS One. 2015;10(2):e0117383. doi:10.1371/journal.pone.0117383
5.Cancelo-Hidalgo MJ, Castelo-Branco C, Palacios S, et al. Tolerability of different oral iron supplements: a systematic review. Curr Med Res Opin. Apr 2013;29(4):291-303.doi:10.1185/03007995.2012.761599
6.Shi H, Chen L, Wang Y, et al. Severity of Anemia During Pregnancy and Adverse Maternal and Fetal Outcomes. JAMA Netw Open. Feb 1 2022;5(2):e2147046. doi:10.1001/jamanetworkopen.2021.47046
7.Kanu FA, Hamner HC, Scanlon KS, Sharma AJ. Anemia Among Pregnant Women Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children - United States, 2008-2018. MMWR Morb Mortal Wkly Rep. Jun 24 2022;71(25):813-819.doi:10.15585/mmwr.mm7125a1
8.Ortiz R, Toblli JE, Romero JD, et al. Efficacy and safety of oral iron(III) polymaltose complex versus ferrous sulfate in pregnant women with iron-deficiency anemia: a multicenter, randomized, controlled study. J Matern Fetal Neonatal Med. Nov 2011;24(11):1347-52.doi:10.3109/14767058.2011.599080
9.Saha L, Pandhi P, Gopalan S, Malhotra S, Saha PK. Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women. MedGenMed. Jan 2 2007;9(1):1.
10. Liu TC, Lin SF, Chang CS, Yang WC, Chen TP. Comparison of a combination ferrous fumarate product and a polysaccharide iron complex as oral treatments of iron deficiency anemia: a Taiwanese study. Int J Hematol. Dec2004;80(5):416-20. doi:10.1532/ijh97.a10409
11.Geisser P. Safety and efficacy of iron(III)-hydroxide polymaltose complex / a review of over 25 years experience. Arzneimittelforschung. 2007;57(6a):439-52. doi:10.1055/s-0031-1296693
12.Devaki PB, Chandra RK, Geisser P. Effects of oral iron(III) hydroxide polymaltose complex supplementation on hemoglobin increase, cognitive function, affective behavior and scholastic performance of adolescents with varying iron status: a single centre prospective placebo controlled study. Arzneimittelforschung. 2009;59(6):303-10. doi:10.1055/s-0031-1296401
13.Bopche AV, Dwivedi R, Mishra R, Patel GS. Ferrous sulfate versus iron polymaltose complex for treatment of iron deficiency anemia in children. Indian Pediatr. Oct 2009;46(10):883-5.
14. Burckhardt-Herold S, Klotz J, Funk F, Büchi R, Petrig-Schaffland J, Geisser P. Interactions between iron(III)-hydroxide polymaltose complex and commonly used drugs / simulations and in vitro studies. Arzneimittelforschung. 2007;57(6a):360-9. doi:10.1055/s-0031-1296684
15.Funk F, Canclini C, Geisser P. Interactions between iron(III)-hydroxide polymaltose complex and commonly used medications / laboratory studies in rats. Arzneimittelforschung. 2007;57(6a):370-5. doi:10.1055/s-0031-1296685