Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial
(1) <b>Background:</b> Postpartum anemia is a common maternal complication and is recognized as a cause of impaired quality of life, reduced cognitive abilities, and fatigue. Efficient iron supplementation for the treatment of postpartum anemia is an essential component of high-quality m...
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| Format: | Article |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/3/758 |
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| author | Lea Bombač Tavčar Hana Hrobat Lea Gornik Irena Preložnik Zupan Marijana Vidmar Šimic Polona Pečlin Gorazd Kavšek Miha Lučovnik |
| author_facet | Lea Bombač Tavčar Hana Hrobat Lea Gornik Irena Preložnik Zupan Marijana Vidmar Šimic Polona Pečlin Gorazd Kavšek Miha Lučovnik |
| author_sort | Lea Bombač Tavčar |
| collection | DOAJ |
| description | (1) <b>Background:</b> Postpartum anemia is a common maternal complication and is recognized as a cause of impaired quality of life, reduced cognitive abilities, and fatigue. Efficient iron supplementation for the treatment of postpartum anemia is an essential component of high-quality maternal care. The optimal mode of iron supplementation has not been determined yet, whether oral or intravenous. The objective of this study was to compare postpartum anemia treatment with intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate. (2) <b>Methods:</b> A single-center, open-label, randomized controlled trial. Women with hemoglobin < 100 g/L within 48 h postpartum were randomly allocated to receive intravenous ferric carboxymaltose, intravenous ferric derisomaltose, or oral ferrous sulfate. Intravenous iron was given in one or two doses, while ferrous sulfate was given as two 80 mg tablets once daily. The primary outcome was maternal fatigue measured by the Multidimensional Fatigue Inventory (MFI) six weeks postpartum. Hemoglobin, ferritin, and transferrin saturation levels were analyzed as secondary outcomes. A Kruskal–Wallis test was used for group comparison (<i>p</i> < 0.05 significant). (3) <b>Results:</b> Three hundred women were included. The MFI score at six weeks postpartum did not differ between groups (median 38 (inter-quartile range (IQR) 29–47) in the ferric carboxymaltose group, median 34 (IQR 26–42) in the ferric derisomaltose group, and median 36 (IQR 25–47) in the ferrous sulfate group; <i>p</i> = 0.26). Participants receiving oral iron had lower levels of hemoglobin (135 (131–139) vs. 134 (129–139) vs. 131 (125–137) g/L; <i>p</i> = 0.008), ferritin (273 (198–377) vs. 187 (155–246) vs. 24 (17–37) µg/L; <i>p</i> < 0.001) and transferrin saturation (34 (28–38) vs. 30 (23–37) vs. 24 (17–37) %; <i>p</i> < 0.001) than those receiving ferric carboxymaltose or ferric derisomaltose. (4) <b>Conclusions:</b> Intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate had similar impacts on maternal fatigue at six weeks postpartum despite improved laboratory parameters in the intravenous groups. |
| first_indexed | 2024-03-08T03:53:57Z |
| format | Article |
| id | doaj.art-b0a9df78a1074acd803ee2b00941e218 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T03:53:57Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b0a9df78a1074acd803ee2b00941e2182024-02-09T15:15:55ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113375810.3390/jcm13030758Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled TrialLea Bombač Tavčar0Hana Hrobat1Lea Gornik2Irena Preložnik Zupan3Marijana Vidmar Šimic4Polona Pečlin5Gorazd Kavšek6Miha Lučovnik7Department of Perinatology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Šlajmerjeva 3, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, SloveniaDepartment of Perinatology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Šlajmerjeva 3, 1000 Ljubljana, SloveniaDepartment of Perinatology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Šlajmerjeva 3, 1000 Ljubljana, SloveniaDepartment of Perinatology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Šlajmerjeva 3, 1000 Ljubljana, SloveniaDepartment of Perinatology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Šlajmerjeva 3, 1000 Ljubljana, Slovenia(1) <b>Background:</b> Postpartum anemia is a common maternal complication and is recognized as a cause of impaired quality of life, reduced cognitive abilities, and fatigue. Efficient iron supplementation for the treatment of postpartum anemia is an essential component of high-quality maternal care. The optimal mode of iron supplementation has not been determined yet, whether oral or intravenous. The objective of this study was to compare postpartum anemia treatment with intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate. (2) <b>Methods:</b> A single-center, open-label, randomized controlled trial. Women with hemoglobin < 100 g/L within 48 h postpartum were randomly allocated to receive intravenous ferric carboxymaltose, intravenous ferric derisomaltose, or oral ferrous sulfate. Intravenous iron was given in one or two doses, while ferrous sulfate was given as two 80 mg tablets once daily. The primary outcome was maternal fatigue measured by the Multidimensional Fatigue Inventory (MFI) six weeks postpartum. Hemoglobin, ferritin, and transferrin saturation levels were analyzed as secondary outcomes. A Kruskal–Wallis test was used for group comparison (<i>p</i> < 0.05 significant). (3) <b>Results:</b> Three hundred women were included. The MFI score at six weeks postpartum did not differ between groups (median 38 (inter-quartile range (IQR) 29–47) in the ferric carboxymaltose group, median 34 (IQR 26–42) in the ferric derisomaltose group, and median 36 (IQR 25–47) in the ferrous sulfate group; <i>p</i> = 0.26). Participants receiving oral iron had lower levels of hemoglobin (135 (131–139) vs. 134 (129–139) vs. 131 (125–137) g/L; <i>p</i> = 0.008), ferritin (273 (198–377) vs. 187 (155–246) vs. 24 (17–37) µg/L; <i>p</i> < 0.001) and transferrin saturation (34 (28–38) vs. 30 (23–37) vs. 24 (17–37) %; <i>p</i> < 0.001) than those receiving ferric carboxymaltose or ferric derisomaltose. (4) <b>Conclusions:</b> Intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate had similar impacts on maternal fatigue at six weeks postpartum despite improved laboratory parameters in the intravenous groups.https://www.mdpi.com/2077-0383/13/3/758postpartum anemiafatigueintravenous iron treatmentoral iron replacementpatient-centered outcome |
| spellingShingle | Lea Bombač Tavčar Hana Hrobat Lea Gornik Irena Preložnik Zupan Marijana Vidmar Šimic Polona Pečlin Gorazd Kavšek Miha Lučovnik Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial Journal of Clinical Medicine postpartum anemia fatigue intravenous iron treatment oral iron replacement patient-centered outcome |
| title | Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial |
| title_full | Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial |
| title_fullStr | Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial |
| title_full_unstemmed | Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial |
| title_short | Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial |
| title_sort | maternal fatigue after postpartum anemia treatment with intravenous ferric carboxymaltose vs intravenous ferric derisomaltose vs oral ferrous sulphate a randomized controlled trial |
| topic | postpartum anemia fatigue intravenous iron treatment oral iron replacement patient-centered outcome |
| url | https://www.mdpi.com/2077-0383/13/3/758 |
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