Parenteral Iron Therapy in the Treatment of Iron Deficiency Anemia During Pregnancy: A Randomized Controlled Trial

Objective: To compare the efficacy and safety profile of total dose infusion of low molecular weight iron dextran with divided doses of intravenous iron sucrose for the treatment of iron deficiency anemia during pregnancy. Study Design: Randomized controlled trial. Place and Duration of Study: Shifa International Hospital, Islamabad, over a period of two years from January 2008 to December 2009. Methodology: Pregnant women at gestational age more than 12 weeks with the confirmed diagnosis of Iron Deficiency Anemia (IDA) were divided into two groups. In the group-A, intravenous iron sucrose was given in divided doses while in the group-B, total daily intake of Low Molecular Weight (LMW) of iron dextran was given. Post-infusion Hemoglobin (Hb) was checked at 4 weeks and at the time of delivery for both groups. Paired sample t-test is applied and comparison (in terms of rise in hemoglobin from pre to post) of both groups was not found to be significant. Results: In the group-A (iron sucrose group), mean pre-infusion Hb levels was 9.09 +/- 0.83 gm/dl. Mean increase in Hemoglobin (Hb) was 10.75 +/- 1.097 gm/dl after 4 weeks of infusion and 11.06 +/- 0.866 gm/dl at delivery (p < 0.001). In group-B (iron dextran group) pre-infusion haemoglobin was 8.735 +/- 0.956 gm/dl and the mean increase in hemoglobin was 10.613 +/- 1.22 gm/dl at 4-week while mean increase of 10.859 +/- 1.11 gm/dl at the time of delivery (p < 0.001). Conclusion: Both LMW iron dextran, as well as iron sucrose are equally effective in treatment of IDA during pregnancy, however, LMW iron dextran has the advantage of single visit treatment.