Iron Infusion

With severe anaemia in pregnancy rising across India, several States are adopting single-dose intravenous (IV) iron therapy, as anaemia is strongly linked to pre-term births and low birth-weight babies

Burden of Anaemia in Pregnancy

• Nature: If untreated during pregnancy, Anaemia can lead to pre-term deliveries, low birth-weight babies, and increased maternal risk.
• Rising Prevalence: Data from National Family Health Survey-5 (2019–21) shows worsening trends despite policy efforts
  • Anaemia prevalence increased to 67.1% among children (6–59 months), 
  • 57% among women (15–49 years), and 
  • 52.2% among pregnant women, compared to NFHS-4 (2015–16)
• Why Pregnancy Aggravates Anaemia ?
  • Increased iron requirement due to Foetal growth and Expansion of maternal blood volume
  • Poor dietary intake and infections further worsen iron deficiency.

About Iron infusion

• Iron infusion is a medical procedure in which iron is delivered directly into a vein (intravenously) through a small catheter. 
• Why iron infusion is needed
  • Iron is essential for making hemoglobin, the protein that carries oxygen in the blood. 
  • When iron levels are too low, the body cannot produce enough hemoglobin, leading to iron-deficiency anemia, the most common form of anemia.
• Types:
• • Oral iron: First-line therapy; inexpensive and effective when taken for at least three months.
  • Intravenous iron: Used when oral iron is not tolerated or absorption is poor.

Limitations of Oral Iron Supplementation

• Poor Compliance: Daily oral iron and folic acid tablets often see low adherence due to gastro-intestinal side effects such as nausea, stomach discomfort, and diarrhoea.

• Clinical Challenge: Oral supplementation is often ineffective for women with moderate to severe anaemia, especially in late pregnancy.
• Behavioural Factors: Many women, particularly during pregnancy, do not prioritise their own health, leading to irregular intake of tablets.

Ferric Carboxymaltose (FCM)

• Single-Dose Advantage: The newer Ferric Carboxymaltose (FCM) formulation requires only a single IV infusion, significantly improving compliance and outcomes.
• Clinical Benefits: According to obstetricians, the single-dose IV FCM leads to faster correction of haemoglobin levels, benefiting both mother and child.
• Late-Pregnancy Utility: It is particularly effective for women in advanced stages of pregnancy, where waiting for oral tablets to act is not feasible

State-Level Adoption

• Rajasthan: A pilot was launched in December 2024 under the National Health Mission-Rajasthan.
  • Rajasthan introduced IV FCM following a district-level study that showed it was highly effective in correcting anaemia in pregnant women.
• Karnataka: Karnataka has begun implementing IV FCM across 31 districts for pregnant women with moderate to severe anaemia.
  • Karnataka launched a digital Garbha Sutra app to calculate correct IV FCM dosage based on haemoglobin levels and body weight.

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