COMPARING ORAL AND INTRAVENOUS IRON IN PREGNANCY: HEMATOLOGICAL OUTCOMES AND TOLERABILITY

Abstract

Background
Iron deficiency anemia (IDA) is a common complication in pregnancy, affecting maternal and fetal health.

Objective
To compare the efficacy and tolerability of oral versus intravenous iron therapy in pregnant women with IDA.

Methodology
This prospective comparative study was conducted at the Department of Gynecology and Obstetrics, Liaqat Memorial Hospital Kohat, from July 2023 to July 2024. Eighty-four pregnant women (14-28 weeks’ gestation) with IDA (Hb <11 g/dL and serum ferritin <30 ng/mL) were randomly randomized to receive oral (ferrous sulfate 325 mg twice daily, n=42) or intravenous (ferric carboxymaltose 1000 mg, n=42) iron At baseline, 4 weeks, and 8 weeks post-therapy, hemoglobin, hematocrit, and serum ferritin were assessed. Tolerability and adverse effects were documented using structured questionnaires. Data were evaluated using independent t-tests and chi-square testing, with p-value < 0.05 deemed significant

Results
The oral group's mean hemoglobin rose from 9.28 ± 0.84 g/dL to 11.36 ± 0.73 g/dL after 8 weeks, whereas the IV group's climbed from 9.15 ± 0.91 g/dL to 12.38 ± 0.67 g/dL (p<0.001). Hematocrit improved from 28.32 ± 2.45% to 33.12 ± 2.21% (oral) and 28.15 ± 2.61% to 36.45 ± 2.17% (IV) (p<0.001). Serum ferritin increased to 42.28 ± 6.47 ng/mL (oral) and 98.36 ± 9.15 ng/mL (IV) (p<0.001). Gastrointestinal side effects were more frequent with oral iron: nausea in 8 patients (19.05%), constipation in 6 patients (14.29%), and epigastric discomfort in 5 patients (11.90%), whereas IV iron caused hypersensitivity in 2 patients (4.76%) and hypotension in 1 patient (2.38%). Overall tolerability was higher in the IV group (92.86%) compared to the oral group (66.67%) (p<0.05).

Conclusion
Intravenous iron is more effective and better tolerated than oral iron in pregnant women with IDA.