Ferric carboxymaltose for anemia in late pregnancy: a randomized controlled trial

Pasricha, SR; Moya, E; Ata&#237;de, R; Mzembe, G; Harding, R; Mwangi, MN; Zinenani, T; Prang, KH; Kaunda, J; Mtambo, OPL; Vokhiwa, M; Mhango, G; Mamani-Mategula, E; Fielding, K; Demir, A; Von Dinklage, N; Verhoef, H; McLean, AR; Manda-Taylor, L; Braat, S; Phiri, KS

Author(s): Pasricha, SR; Moya, E; Ataíde, R; Mzembe, G; Harding, R; Mwangi, MN; Zinenani, T; Prang, KH; Kaunda, J; Mtambo, OPL; Vokhiwa, M; Mhango, G; Mamani-Mategula, E; Fielding, K; Demir, A; Von Dinklage, N; Verhoef, H; McLean, AR; Manda-Taylor, L; Braat, S; Phiri, KS;
Details: Publication Year 2025-01,Volume 31,Issue #1,Page 197-206
Journal Title: Nature Medicine
Publication Type: Research article
Abstract: Over 46% of African pregnant women are anemic. Oral iron is recommended but often suboptimal, particularly late in pregnancy. Intravenous ferric carboxymaltose (FCM) could treat anemia in women in the third trimester in sub-Saharan Africa. In an open-label, individually randomized trial in antenatal clinics in southern Malawi, we randomized 590 women at 27-35 weeks of gestation with capillary hemoglobin <10.0 g dl(-1) to FCM (20 mg kg(-1) up to 1,000 mg, once at enrollment) or standard of care (60 mg elemental iron, twice daily for 90 days). Participants and their infants were followed to 4 weeks postpartum. Primary outcomes were maternal anemia at 36 weeks' gestation or delivery (whichever occurred first) and neonatal birthweight. At the primary timepoint, 126 of 270 (46.7%) of women in the FCM group were anemic, compared to 170 of 271 (67.3%) women in the standard-of-care group (PR, 0.74 (95% CI 0.64, 0.87); P = 0.0002). There was no difference between groups in birthweight (mean difference 10.9 g (-65.7, 87.5 g); P = 0.78). No serious infusion-related reactions occurred, and there were no differences in adverse events between groups. In Malawian women in late pregnancy, FCM effectively and safely reduced anemia before childbirth. Australia New Zealand Clinical Trial registration: ANZCTR12621001239853.
Publisher: Springer Nature
Keywords: Humans; Female; Pregnancy; *Ferric Compounds/therapeutic use/administration & dosage/adverse effects; *Maltose/analogs & derivatives/therapeutic use/administration & dosage/adverse; effects; Adult; *Anemia/drug therapy; Malawi; Pregnancy Trimester, Third; *Anemia, Iron-Deficiency/drug therapy; *Pregnancy Complications, Hematologic/drug therapy; Infant, Newborn; Hemoglobins/metabolism; Birth Weight/drug effects; Young Adult
Department(s): Haematology
Publisher's Version: https://doi.org/10.1038/s41591-024-03385-w
Open Access at Publisher's Site: https://doi.org/10.1038/s41591-024-03385-w
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-01-21 06:45:05

Last Modified: 2026-01-13 05:40:51