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A Randomized Controlled Trial Comparing Ferric Carboxy-Maltose With Iron Sucrose Complex for Postpartum
Chanderdeep Sharma1, Manupriya Sharma2, Varun Kapoor3
1Obstetrics and Gynecology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND.
Cureus
|October 27, 2025
Summary
Ferric carboxymaltose (FCM) is more effective and has better compliance than iron sucrose complex (ISC) for treating postpartum iron-deficiency anemia. FCM is recommended as a standard treatment, especially in low-resource settings.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Pharmacology
Background:
- Postpartum iron-deficiency anemia (IDA) is a common complication affecting maternal health.
- Parenteral iron therapy is crucial for managing severe or refractory IDA.
- Comparing different parenteral iron formulations is essential for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the efficacy and compliance of ferric carboxymaltose (FCM) versus iron sucrose complex (ISC) in treating postpartum IDA.
- To compare improvements in hemoglobin, red blood cell indices, and iron stores between the two treatments.
- To assess the safety and maternal complication profiles of FCM and ISC.
Main Methods:
- A randomized controlled trial involving 500 postpartum women with IDA.
- Primary outcomes included changes in hemoglobin, RBC indices (MCV, MCH, MCHC), and iron stores (serum ferritin, transferrin saturation).
- Secondary outcomes assessed side effects and maternal complications over a four-week follow-up period.
Main Results:
- FCM treatment resulted in significantly higher hemoglobin levels and improved RBC indices compared to ISC.
- FCM demonstrated superior improvements in iron stores (serum ferritin, transferrin saturation) versus ISC.
- Compliance was significantly better with FCM, with fewer patients requiring repeated doses; side effect profiles and maternal complications were comparable.
Conclusions:
- Ferric carboxymaltose (FCM) offers superior efficacy and compliance for postpartum iron-deficiency anemia compared to iron sucrose complex (ISC).
- FCM is recommended as a standard parenteral treatment for postpartum IDA, particularly in low- and middle-income countries.
- A single dose of 1000 mg FCM before hospital discharge is suggested for eligible patients.
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