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Comparative Efficacy of Ferrous, Ferric and Liposomal Iron Preparations for Prophylaxis in Infants
Betül Orhan Kiliç1, Dilek Konuksever2, Namik Yasar Özbek3
1Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Turkey. Correspondence to: Dr. Betül Orhan Kiliç, Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Turkey. betulorhandr@hotmail.com.
Insights
Ferrous iron supplementation is more effective in preventing iron deficiency anemia in infants than ferric or liposomal iron. This study highlights ferrous iron as a preferred choice for infant iron prophylaxis.
Area of Science:
- Pediatric Nutrition
- Hematology
- Pharmacology
Background:
- Iron deficiency anemia (IDA) is a prevalent nutritional deficiency in infants.
- Oral iron supplementation is a common strategy for IDA prevention.
- Various oral iron preparations exist, with differing reported efficacies.
Purpose of the Study:
- To compare the efficacy of different oral iron preparations for preventing iron deficiency anemia in infants.
- To evaluate ferrous, ferric, and liposomal iron formulations in a pediatric population.
Main Methods:
- Retrospective analysis of 371 infants aged 6-12 months receiving iron prophylaxis from 4 months of age.
- Categorization of iron preparations into ferrous (Fe+2), ferric (Fe+3), and liposomal iron.
- Assessment of complete blood counts and serum ferritin levels.
- Statistical comparison using Chi-square and regression analyses.
Main Results:
- Ferrous iron group showed significantly lower rates of iron deficiency (5.0%) compared to ferric (44.5%) and liposomal iron (46.0%).
- Higher mean hemoglobin and serum ferritin levels were observed in infants receiving ferrous iron.
- Multivariate analysis indicated ferrous iron was associated with a significantly lower risk of iron deficiency.
Conclusions:
- Ferrous iron preparations demonstrated superior efficacy in preventing iron deficiency anemia in infants compared to ferric and liposomal iron.
- Findings suggest ferrous iron as a more effective option for infant iron prophylaxis.
- Further research is warranted to explore alternative iron preparations for pediatric use.
Objective:
This study aimed to assess the efficacy of different oral iron preparations prescribed for prevention of iron deficiency anemia in healthy infants.
Methods:
This retrospective study enrolled infants aged between 6 and 12 months who were initiated on iron prophylaxis at four months of age. Enrolled children consistently used specific iron preparations (ferrous, ferric or liposomal iron) and had their complete blood counts and serum ferritin levels assessed within the 6-12 month timeframe. Blood values and iron prophylaxis type (ferrous (Fe+2), ferric (Fe+3), liposomal iron) were recorded. Chi-square test was used to compare the hemoglobin and ferritin levels levels between groups. Univariate and multivariate regression analyses assessed the risk of anemia.
Results:
The study included 371 children (ferrous sulphate - 60, iron hydroxide-polymaltose complex - 137 and liposomal ferric pyrophosphate - 174) with a mean (SD) age 9.1 (1.3) mo. Iron deficiency in different groups were: liposomal iron (46.0%), ferric iron (44.5%), and ferrous iron (5.0%). Mean (SD) serum ferritin levels (µg/L) were higher in the ferrous group [30.1 (10.8)] compared to infants receiving ferric [17.6 (14.50)] and liposomal iron [15.4 (12.1)] (P < 0.001). Mean (SD) hemoglobin levels (g/dL) were significantly higher in the ferrous group [12.4 (0.8)] compared to ferric [11.9 (1.1)] and liposomal iron group [12.0 (1.1)]; P =0.008. Multiple regression analysis showed that ferrous group was associated with a lower risk of iron deficiency [OR (95% CI) 0.04 (0.01-0.15), P < 0.001].
Conclusion:
Ferrous iron demonstrated superior efficacy compared to ferric and liposomal iron. Further studies are needed to establish alternative iron preprations in children.
