Efficacy of a combined drug containing ferrous fumarate and folic acid in anemia in the second trimester of pregnancy: results of a multicenter study

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Abstract

Objective: To evaluate the effect of ferrous fumarate/folic acid (FF/FA) on the clinical and laboratory signs of anemia in pregnant women in the second trimester.

Materials and methods: The investigation enrolled 160 women at 14 to 20 weeks’ gestation who were diagnosed with anemia and were prescribed FF/FA.

Results: The use of FF/FA caused a significant improvement in clinical and biochemical blood test results reflecting the severity of anemia: an increase in Hb, Ht, RBC, MCV, MCH, MCHC, serum iron, and ferritin, a decrease in the frequency of microcytosis and serum latent iron-binding capacity. After 3 months of therapy, the total study population displayed an increase in mean values of HgB from 102.0 to 117.0 g/l, ferritin from 46.2 to 55.9 µg/l, serum iron from 12.02 to 20.49 µmol/l. The proportion of patients without anemia was 77% (118/153); that with mild and moderate anemia were 20% (31/153), and 2% (3/153), respectively, which shows a significant improvement compared to that at the start of therapy. In the group with iron deficiency anemia (IDA), (Hb<110 g/l, ferritin<30 µg/l), Hb increased from an average of 103.3 to 109.8 g/l, ferritin from 14.4 to 24.3 µg/l, serum iron from 11.87 to 20.53 µmol/l. After 3 months, mild and moderate IDA was present in 30% (28/93) and 3% (3/93) patients, respectively.

Conclusion. The findings are comparable with international and Russian data and can conclude that FF/FA is an effective and safe way to correct IDA in pregnant women and is suitable for long-term use.

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About the authors

Stanislav V. Pavlovich

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: s_pavlovich@oparina4.ru
ORCID iD: 0000-0002-1313-7079

PhD, Academic Secretary; Professor, Department of Obstetrics, Gynecology, Perinatology and Reproductology

Russian Federation, Moscow

Oleg G. Melikhov

Scientific Society “League for Promoting Clinical Trials”; Institute of Clinical Research

Author for correspondence.
Email: melikhov.oleg@gmail.com
ORCID iD: 0000-0001-9442-7707

PhD, Director; Chairman

Russian Federation, Moscow; Moscow

Zulfiya S. Khodzhaeva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: zkhodjaeva@mail.ru
ORCID iD: 0000-0001-8159-3714

Dr. Med. Sci., Professor, Deputy Director of Obstetrics Institute, Professor at the Department of Obstetrics, Gynecology, Perinatology of the Department of Professional Education

Russian Federation, Moscow

Kamilla T. Muminova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: kamika91@mail.ru
ORCID iD: 0000-0003-2708-4366

PhD, Researcher at the High Risk Pregnancy Department

Russian Federation, Moscow

Viktoriya A. Sakalo

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_sakalo@oparina4.ru
ORCID iD: 0000-0002-5870-4655

PhD, Junior Researcher at the Department of Pregnancy Pathology, Institute of Obstetrics, doctor at the 1st Obstetric Department of Pregnancy Pathology

Russian Federation, Moscow

Elena A. Gorodnova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: e_gorodnova@oparina4.ru
ORCID iD: 0000-0003-3993-7629
Scopus Author ID: 6508176604

PhD, MPH (Master of Public Health), Head of Scientific & Clinical Center

Russian Federation, Moscow

Elena I. Abashova

D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology

Email: abashova@yandex.ru
ORCID iD: 0000-0003-2399-3108
SPIN-code: 2133-0310

PhD, Senior Researcher, Department of Gynecology and Endocrinology

Russian Federation, Saint Petersburg

Maria I. Yarmolinskaya

D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology

Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN-code: 3686-3605

Professor of RAS, Dr. Med. Sci., Professor, Head of the Department of Gynecology and Endocrinology, Head of Center “Diagnostics and treatment of endometriosis”; Professor at the Department of Obstetrics and Gynecology

Russian Federation, Saint Petersburg

Vasilii S. Chulkov

City Center for Hemostatic Pathology

Email: vschulkov@rambler.ru
ORCID iD: 0000-0002-0952-6856

Dr. Med. Sci., Professor at the Department of Faculty Therapy

Russian Federation, Chelyabinsk

Zulfira M. Nazipova

Republican Clinical Hospital, Ministry of Health of the Republic of Tatarstan

Email: zulfira93@mail.ru
ORCID iD: 0009-0002-3591-522X

hematologist

Russian Federation, Kazan

Irina V. Savelyeva

Omsk State Medical University, Ministry of Health of Russia

Email: saveljeva_iv_omsk@mail.ru
ORCID iD: 0000-0001-9342-7342

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 1

Russian Federation, Omsk

Margarita D. Andreeva

Kuban State Medical University, Ministry of Health of Russia

Email: andreeva_md@mail.ru
ORCID iD: 0000-0002-6524-3965

Dr. Med. Sci., Associate Professor, Professor at the Department of Obstetrics, Gynecology and Perinatology, Faculty of Postgraduate Education

Russian Federation, Krasnodar

Yulia V. Kudlai

Kuban State Medical University, Ministry of Health of Russia

Email: kudlai.j@yandex.ru
ORCID iD: 0000-0002-3192-7170

student of the Faculty of Pediatrics

Russian Federation, Krasnodar

Elena V. Enkova

Voronezh City Clinical Polyclinic No. 1

Email: enkova@bk.ru
ORCID iD: 0000-0001-8885-1587

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 2

Russian Federation, Voronezh

Aliya Sh. Zaripova

Nurmed Medical Center

Email: zaripovaash@yandex.ru
ORCID iD: 0000-0002-2701-319X

postgraduate student of the Department of Obstetrics and Gynecology named after V.S. Gruzdev; Chief Physician, obstetrician-gynecologist, ultrasound diagnostics doctor

Russian Federation, Kazan

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2. Figure. Distribution of pregnant women (N) according to the severity of anemia during VF/FC therapy

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