(653) Does Early Administration of IV Iron During Pregnancy Improve Maternal Morbidity?

Objective: Anemia in pregnancy is a significant contributor to maternal morbidity, including increased risks of blood transfusion, longer hospital stays, depression, preterm birth, and low birth weight. Oral (PO) iron has been traditionally recommended for its simplicity and cost-effectiveness but often suffers from poor adherence and gastrointestinal side effects. This study aims to investigate whether early administration of IV iron can improve hemoglobin (Hgb) levels prior to delivery and decrease the need for blood transfusion.

Study Design: Patients with a ferritin level < 30 ng/mL were recruited. Exclusion criteria included age < 18, multifetal gestations, thalassemia or sickle cell disease, and chronic kidney or liver disease. After obtaining consent, patients were randomly assigned to either the PO or IV iron groups. The PO iron group received Ferrous sulfate 325 mg every other day, while the IV iron group received Venofer 200 mg every other day until the iron deficit was corrected. Hgb and ferritin levels were assessed before treatment and four weeks after treatment initiation. Patients also completed an anemia symptom questionnaire at enrollment and at the 4-week mark. Statistical comparisons were conducted using two-tailed T-tests with significance set at P < 0.05.

Results: The IV iron group showed a significant increase in Hgb and ferritin levels compared to the PO iron group four weeks after treatment, with P-values of 0.002 and 0.0001, respectively. The blood transfusion rate was 3.7% in the PO iron group and 0% in the IV iron group.

Conclusion: Our findings demonstrate a significant improvement in ferritin levels among patients treated with IV iron compared to those receiving PO iron therapy. Additionally, the absence of blood transfusions in the IV iron group highlights its potential in reducing alloimmunization and blood transfusion reactions, suggesting that early administration of IV iron during pregnancy can improve maternal health outcomes.