The Effect of Ferric Carboxymaltose Versus Iron Sucrose on Hemoglobin Levels in Pregnant Women with Anemia: Meta-Analysis

Astika Candra Nirwana, Yulia Lanti Retno Dewi, Bhisma Murti


Background:  Anemia in pregnant women is one of the global health problems experienced by deve­­­loped or developing countries affecting 1.62 billion world population, which corresponds to 24.8% of the population in the world. Anemia is a serious problem for mater­nal health because it is one of the five problems that becomes the target of solving the World Health Organization (WHO) in 2025. This study aimed to estimate the mag­nitude of the effect of Ferric Carboxymaltose on hemoglobin levels in pregnant women with anemia compared to Iron Sucrose.

Subjects and Method: This study was a meta-analysis study. The study was conducted by look­ing for data from the study results in the period 2010-2019. The data of this study was from Pubmed, DOAJ, Science Direct, Springer Link, Web of Science, Cochrane, Google Scholar, BMJ, BMC, Research Gate, J Stor, Wiley, Clinical Key, J Gate, SAGE, IEEE Xplore, ERIC Institute of Education Science, BASE, SciELO, WorldCat, Microsoft Academic, Index Copernicus, CABI, Cambridge, Nature, Oxford, ProQuest, and BJOG using the keyword "ferric carboxymaltose" AND "iron sucrose" AND "anemia in pregnancy" AND "ran­do­mized control trial" OR RCT, "ferric carboxy­maltose" AND "iron sucrose" AND "hemo­globin in pregnancy" AND "randomized control trial".  The subjects of this study were pregnant women with anemia. The study used a Revman 5.3 application to analyze the article.

Results: The eight articles were reviewed using the meta-analysis technique in this study. Preg­nant women who were given ferric carboxy­maltose therapy had a higher mean hemoglobin level than those who were not treated carboxy­maltose therapy and it was  statistically signi­fi­cant (SMD= 1.11; 95% CI= 0.37 to 1.85; p= 0.003). The heterogeneity of the data showed I2= 98% so that the distribution of the data was stated to be heterogeneous (random effect model).

Conclusion: Ferric Carboxymaltose is effec­tive in increasing hemoglobin levels in preg­nant women with anemia.

Keywords: Ferric Carboxymaltose, Iron Sucrose, Randomized Controlled Trial.

Correspondence: Astika Candra Nirwana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: astikacandranirwana2796@­g­ Mobile: 085640018896.

Journal of Maternal and Child Health (2021), 06(01): 15-24


Full Text:



Bekele A, Tilahun M, Mekuria A (2016). Prevalence of anemia and its associated factors among pregnant women attending antenatal care in Health Institutions of Arba Minch Town, Gamo Gofa Zone, Ethiopia: A CrossSectional Study. Anemia. 2016: 1073192.

Bilimale A, Anjum J, Sangolli HN, Mallapur M (2010). Improving adherence to oral iron supplementation during pregnancy. Maternal Health, Nutrition, Anae-mia. 3(5): 281-290.

Camaschella C (2015). Iron-deficiency ane-mia. New England Journal of Medicine.372(19): 1832–1843.

Christoph P, Schuller C, Studer H, Irion O, De Tejada BM, Surbek D (2012). Intra-venous iron treatment in pregnancy: Comparison of high-dose ferric carbo-xymaltose vs. iron sucrose. Journal of Perinatal Medicine, 40(5): 469–474.

Gogoi I, Mahanta TG, Sarma PR, Gogoi PP, Saikia H (2016). Prevalence and socio-demographic factors affecting anaemia in pregnant women of Dibrugarh district, Assam, India. Indian Journal of Community Health, 28(2): 202–207.

Jose A, Mahey R, Sharma JB, Bhatla N, Saxena R, Kalaivani M, Kriplani A (2019). Comparison of ferric carboxy-maltose and iron sucrose complex for treatment of iron deficiency anemia in pregnancy-randomised controlled trial. BMC Pregnancy and Childbirth, 19(1): 1-8.

Khaskheli M, Baloch S, Baloch AS, Baloch S, Khaskheli FK (2016). Iron deficiency anaemia is still a major killer of preg-nant women. Pakistan Journal of Medi-cal Sciences. 32(3): 630–634.

Mahajan AR, Bhagat B, Gupta S, Mahajan B, Verma M (2018). A comparative study of efficacy and safety of intravenous ferric carboxymaltose versus iron su-crose in the treatment of iron deficiency anaemia of pregnancy in a tertiary care hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(5): 1938.

Murti B (2018). Prinsip dan metode riset epidemiologi. Edisi IV. Surakarta: Bin-tang Fajar Offset.

Naqash A, Ara R, Bader GN (2018). Effecti-veness and safety of ferric carboxy-maltose compared to iron sucrose in women with iron deficiency anemia: phase IV clinical trials. BMC Women’s Health, 18(1): 6.

Neogi SB, Devasenapathy N, Singh R, Bhus-han H, Shah D, Divakar H, Baswal D (2019). Safety and effectiveness of intravenous iron sucrose versus stan-dard oral iron therapy in pregnant women with moderate-to-severe anae-mia in India: a multicentre, open-label, phase 3, randomized, controlled trial. The Lancet Global Health, 7(12): e1706–e1716.

Patel R, Delivala K, Bhatt S (2019). Paren-teral iron treatment in pregnancy: comparision of high-dose ferric carbo-xymaltose vs. iron sucrose. 8(9): 46–49.

Pavord S, Myers B, Robinson S, Allard S, Strong J, Oppenheimer C (2012). UK guidelines on the management of iron deficiency in pregnancy. British Journal of Haematology. 156(5): 588–600.

Qassim A, Mol, BW, Grivell RM, Grzeskowiak LE (2018). Safety and efficacy of intravenous iron polymaltose, iron sucrose and ferric carboxymaltose in pregnancy: A systematic review. Australian and New Zealand Journal of Obstetrics and Gynecology, 58(1): 22–39.

Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, Ota E, et al (2016). Maternal anemia and risk of adverse birth and health outcomes in low and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr. 103(02): 495–504.

Reveiz L, Gyte GM, Cuervo LG, Casasbuenas A (2011). Treatments for iron deficiency anaemia in pregnancy. Cochrane Data-base of Systematic Reviews. (2): CD0-03094. 094.pub3.

World Health Organization. (2014). World Health Statistic. Geneva: WHO.


  • There are currently no refbacks.