Safety and Efficacy of Ferric Carboxymaltose Therapy in Post-Partum Women with Iron Deficiency Anemia

World Health Organization has defined post-partum anaemia as haemoglobin of less than 10gm % during the post-partum period. WHO estimates two-thirds of maternal deaths occur after delivery. Post-partum haemorrhage being the most commonly reported complication and the leading cause of maternal death (29.6 %). Post-partum anaemia has been associated with post-partum depression, stress, anxiety, cognitive impairment, poor mother-infant interactions and delayed infant development. Oral iron therapy is currently the treatment of choice for the majority of patients with iron deficiency anemia but it has disadvantages like poor absorption, poor compliance and gastro-intestinal (GI) side effects. Packed cell transfusion is reserved for cases with severe anaemia but carries significant risk of transmission of blood transmissible diseases as well as risk of anaphylactic and allergic reactions. Parenteral iron helps in restoring iron stores faster and more effectively than oral iron. Intravenous (IV) iron sucrose is safe, effective and economic in comparison to the repeated and painful intramuscular iron injections. Although the incidence of anaphylaxis and other adverse reactions with intravenous iron sucrose is markedly lower, multiple doses and prolonged infusion times are typically required. Ferric carboxymaltose is a novel molecule composed of a poly-nuclear iron (III) hydroxide complexes to carboxymaltose. Intravenous ferric carboxymaltose has a neutral pH (5.0-7.0) and physiological osmolarity which makes it possible to administer its higher single dose over shorter time period (single dose up to 1000 mg over 15 min) than other parenteral preparations. Ferric carboxymaltose is cost effective with other positive benefits of fewer hospital visits and improved patient compliance.