Increase in hemoglobin among the mothers at different levels of hemoglobin.

Sir,

We wish to comment on the article entitled “Iron Sucrose Versus Oral Iron Therapy in Pregnancy Anemia” published in October 2012 issue of Indian Journal of Community Medicine.(1) The research communication was extremely informative keeping in view of high prevalence of anemia amongst pregnant women 58.7% (<12.0 g/dl) and non-pregnant women 55.3% (<12.0 g/dl) as per National Family Health Survey-3 (NFHS-3) 2005-06 data.(2)

The investigators found that there was a mean increase of hemoglobin of 1.31 g/dl in oral iron group and 2.06 g/dl in intravenous group. The small increase in hemoglobin may be because there are other causes of anemia like micronutrient deficiencies (e.g., folate, B12 and Vitamin A deficiencies), helminthic infestations, malaria and hemoglobinopathies. The investigators found that there was an increase in hemoglobin in oral iron group from 9.75 g/dl to 11.06 g/dl and in intravenous iron group from 9.18 g/dl to 11.24 g/dl.

It would have been scientifically more valid if the increase in hemoglobin amongst the mothers at different levels of hemoglobin viz: Hb 7-8 g/dl, 8-9 g/dl, 9-10 g/dl and 10-11 g/dl in two groups is shared with readers of IJCM. This information would be important for policy makers.

The pregnant women of hemoglobin 6.5 g/dl were included in the study, who was suffering from severe anemia. This is ethically wrong as these women require treatment.