Low-dose weekly intravenous iron sucrose versus daily oral iron for iron deficiency anemia in late pregnancy: A randomized controlled trial

Objective: To compare the efficacy of low-dose weekly intravenous iron sucrose with oral iron for iron deficiency anemia (IDA) in late pregnancy. Material and Method: Eighty singleton pregnant women with IDA at 33 weeks gestation were randomized to receive either oral ferrous fumarate 200 mg of elemental iron daily until delivery (OFF-group) or 200 mg of intravenous iron sucrose complex weekly up to 500 mg (ISC-group). Hematological and complete iron profiles were assessed at 36 weeks gestation and at delivery. Pregnancy outcome and adverse drug reaction were recorded. Results: A gradual increase of hemoglobin (Hb) level was observed in both groups at 36 weeks’ gestation and at delivery. Median serum ferritin level in the ISC-group was 4.7 times of that in the OFF-group at 36 weeks’ gestation (123.8 (90.4, 176.2) vs. 26.2 (18.9, 38.1) μg/L; p<0.001) and remained 2.3 times at delivery (66.3 (32.6, 93.7) vs. 28.3 (20.6, 38.9) μg/L; p<0.001). No serious side effect was detected. Both groups had similar mean infant birth weight. Conclusion: Low-dose intravenous iron sucrose complex in weekly divided infusions is more efficacious in replenishing iron storage but not more efficacious in raising hemoglobin level compared with daily oral ferrous fumarate for pregnant women with IDA in late pregnancy.