Comparative Efficacy between Intravenous Iron and Oral Iron on Enhancing Hemoglobin Level among Pregnant Women with Iron Deficiency Anemia in Low and Middle Income Countries: A Meta-Analysis
Abstract
Background: Iron deficiency was a major cause of anemia in pregnancy. The incidence of large deficiency anemia was mostly experienced in pregnancy which can result in general hematological disorders with considerable complications both for the mother and the fetus. This study aimed to compare the efficacy of intravenous iron administration and oral iron for the treatment of iron deficiency anemia in pregnancy.
Subjects and Method: This was a meta-analysis conducted using PRISMA systematic guidelines. The process of searching articles was carried out between 2000 and 2018 using a database search engine consisting of; PubMed, Science Direct, Springer Link, and Google Scholar. Based on database searches, nine articles that met the Randomized Control Trial (RCT) criteria and study were conducted in lower middle income countries. This study involved 967 samples divided into two groups of 484 intravenous iron and 483 oral iron. The analysis was carried out with Review Manager (RevMan) software 5.3. The results were assessed for Mean Difference (MD) and the analysis was carried out for heterogeneity.
Results: There was a high heterogeneity between experiments (I2= 91%; p <0.001) so that Random Effects Model (REM) was used. Intravenous iron administration can increase hemoglobin levels 0.70 g / dL higher than oral iron administration, and it was statistically significant (MD 0.70; 95 % CI: 0.37 to 1.02; p<0.001).
Conclusion: Intravenous iron administration was more effective than oral iron for the treatment of iron deficiency anemia in pregnancy. Pregnant women given intravenous iron more quickly reach the desired hemoglobin level target than oral iron.
Keywords: anemia, iron deficiency, intravenous iron, oral iron, meta-analysis
Correspondence: Fiki Cahya Ningrum. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: ningrum.fiki@gmail.com. Mobile: 081216494956.
Indonesian Journal of Medicine (2019), 4(2): 135-144
https://doi.org/10.26911/theijmed.2019.04.02.07
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