Maternal and Perinatal Outcomes Following Parenteral Iron Therapy for Iron Deficiency Anemia in the Third Trimester: A Comparative Cross-Sectional Study

Abstract

Background: Iron deficiency anemia (IDA) constitutes a significant public health concern during gestation, correlating with considerable
maternal and fetal morbidity. Although oral iron is recognized as the primary treatment modality, its inherent limitations frequently result in
insufficient correction, particularly when therapy is commenced in the later stages of pregnancy. Parenteral iron facilitates expedited restoration
of hemoglobin levels; however, thorough evaluations of clinical outcomes in comparison to oral therapy during the third trimester remain
imperative.
Objective: The aim of this study is to evaluate maternal and perinatal outcomes among antenatal women experiencing moderate-to-severe IDA
who are administered either parenteral iron or oral iron between 28 and 36 weeks of gestation.
Methods: This comparative cross-sectional investigation encompassed a cohort of 200 women diagnosed with IDA (Hb <10.0 g/dL). Group A
(n=100) was treated with intravenous iron sucrose/ferric carboxymaltose, whereas Group B (n=100) continued with oral iron supplementation.
The outcomes assessed included the increment in hemoglobin levels, requirement for transfusion, incidence of postpartum hemorrhage (PPH),
birth weight, neonatal vitality, and necessity for NICU admission.
Results: The average increase in hemoglobin levels was markedly superior in Group A (2.8 ± 0.9 g/dL vs. 1.2 ± 0.6 g/dL; p<0.001). The need
for transfusion (2% vs. 11%; p=0.016) and the occurrence of PPH (4% vs. 13%; p=0.021) were significantly reduced in the parenteral group.
Perinatal outcomes were also more favorable in Group A, which exhibited a higher mean birth weight (2850g vs. 2650g; p=0.003), lower
incidence of small-for-gestational-age infants (8% vs. 19%; p=0.022), and diminished NICU admissions (10% vs. 22%; p=0.018).
Conclusion: The administration of parenteral iron during the third trimester for moderate-to-severe IDA leads to enhanced hemoglobin correction
and improved maternal and perinatal outcomes in comparison to oral iron, thereby endorsing its application in cases of late-presenting anemia.