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Comparison of Different Iron Preparations in the Prophylaxis of Iron-deficiency Anemia
Ali Aydin1, Emel Gur, Tugba Erener-Ercan
1Departments of *Pediatrics †Social Pediatrics §Public Health, Istanbul University Cerrahpasa Medical Faculty ‡Department of Neonatology, Maltepe University, Medical Faculty, Istanbul, Turkey.
Insights
Divalent iron sulfate and trivalent ferric polymaltose effectively prevent iron-deficiency anemia in infants. Divalent iron showed slightly better results in hemoglobin and iron levels, with similar side effects for both iron supplements.
Area of Science:
- Pediatrics
- Hematology
- Nutritional Science
Background:
- Iron-deficiency anemia (IDA) is a prevalent nutritional deficiency in infants.
- Exclusively breast milk-fed infants are at risk for IDA due to low iron content in breast milk.
- Prophylaxis with iron supplements is crucial for preventing IDA in this population.
Purpose of the Study:
- To compare the efficacy of ferrous sulfate (divalent) and ferric polymaltose (trivalent) for iron-deficiency anemia prophylaxis in exclusively breast milk-fed term infants.
- To evaluate the impact of these iron preparations on hemoglobin, hematocrit, serum iron, and transferrin saturation.
- To assess the incidence of iron deficiency and IDA and compare side effects between the two iron preparations.
Main Methods:
- A randomized controlled trial involving 112 exclusively breast milk-fed term infants.
- Infants were divided into two groups at 4 months of age.
- Group 1 received ferrous sulfate (divalent iron) and Group 2 received ferric polymaltose (trivalent iron) at a dose of 2 mg/kg/d for 5 months.
Main Results:
- Both iron preparations significantly increased hemoglobin, hematocrit, serum iron, and transferrin saturation by 9 months of age.
- The divalent iron group showed significantly higher levels of hemoglobin, hematocrit, mean corpuscular volume, serum iron, and transferrin saturation compared to the trivalent iron group.
- Incidence of iron deficiency and IDA, as well as reported side effects, were not significantly different between the two groups.
Conclusions:
- Both ferrous sulfate and ferric polymaltose are effective in preventing iron deficiency and IDA in exclusively breast milk-fed infants.
- Divalent iron (ferrous sulfate) demonstrated slightly superior efficacy in improving hematological parameters.
- Both iron preparations exhibit comparable safety profiles with similar side effects.
Abstract:
We compared the efficacy of ferrous sulfate (divalent) and ferric polymaltose (trivalent) compounds for the prophylaxis of iron-deficiency anemia (IDA). Study infants included exclusively breast milk-fed term infants. Subjects were divided randomly into 2 groups at 4 months of age and group 1 (n=56) received divalent and group 2 (n=56) received trivalent iron (Fe) preparation at a dose of 2 mg/kg/d for 5 months. At 9 months of age, after a 5-month prophylaxis, a significant increase was observed in hemoglobin (Hb), hematocrit, serum Fe levels, and transferrin saturation in both groups. However, group 1 had significantly higher Hb, hematocrit, mean corpuscular volume, Fe, and transferrin saturation than group 2 (11.7±0.6 g/dL, 34.6%±1.7%, 76.2±2.9 fL, 55.5±1.8 mcg, 20.8±3.9 g/L, respectively in group 1 vs. 11.3±0.5 g/dL, 33.5%±1.5%, 74.7±3.2 fL, 42.5±1.8 mcg, 14.1±7.5 g/L, respectively in group 2). No significant difference was found in ferritin values between the groups. Fe deficiency was found in 17 (30.3%) of the subjects in group 1, and 23 (41%) of subjects in group 2 whereas 5 (8.9%) subjects had IDA in group 1 and 12 (12%) in group 2 which were insignificant between groups. No significant difference was found with regard to side effects between 2 Fe preparations. Although divalent Fe therapy led to a higher Hb and serum Fe level, both ferrous and ferric Fe preparations were effective for prophylactic use in the prevention of Fe deficiency and IDA with comparable side effects.