Iron therapy in iron deficiency anemia in pregnancy: Intravenous route versus oral route

OBJECTIVE: The aim of this study was to compare intravenous iron sucrose versus oral iron sulfate in anemia at 6 months of pregnancy. STUDY DESIGN: A random, prospective, open study with individual benefit was performed involving 50 patients with hemoglobin levels between 8 and 10 g/dL and a ferritin value of <50 μg/L. In the intravenous group (IV group), the iron dose was calculated from the following formula: Weight before pregnancy (kg) × (120 g/L – Actual hemoglobin [g/L]) × 0.24 + 500 mg. The oral group (PO group) received 240 mg of iron sulfate per day for 4 weeks. Treatment efficacy was assessed by measurement of hemoglobin and reticulocytes on days 8, 15, 21, and 30 and at delivery and of ferritin on day 30 and at delivery. The babyʹs birth weight and iron stores were noted. Results were expressed as median ± interquartile range. Mann-Whitney and Wilcoxon tests were used for the analysis, with P < .05 considered significant. RESULTS: An increase in hemoglobin was observed, rising from 9.6 ± 0.79 g/dL to 11.11 ± 1.3 g/dL on day 30 in the IV group and from 9.7 ± 0.5 g/dL to 11 ± 1.25 g/dL on day 30 in the PO group (not significant). On day 30 (P < .0001) and at delivery (P = .01) ferritin was higher in the IV group. A mean higher birth weight of 250 g was noted in the IV group (not significant). CONCLUSION: Iron sucrose appears to be a treatment without serious side effects indicated in correction of pregnancy anemia or iron stores depletion. (Am J Obstet Gynecol 2002;186:518-22.)