Low-Dose Weekly Intravenous Iron Sucrose versus
Daily Oral Iron for Iron Deficiency Anemia in Late
Pregnancy: A Randomized Controlled Trial
Pornpimol Ruangvutilert MD, PhD* , Pharuhas Chanprapaph MD, MSc*,
Prakong Chuenwattana BN, PhD*, Vitaya Titapant MD*, Chulaluk Komoltri DrPH**
Affiliation :
* Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynaecology,
Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Division of Clinical Epidemiology, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
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.
Keywords : intravenous iron sucrose, oral iron, iron deficiency anemia, hemoglobin, serum ferritin, iron storage
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