Skip to main content
SMFM 2025 Pregnancy Meeting Main banner
Final Program


Program Book
Icon Legend
Presentation Icons
Additional registration fee required
Additional registration fee required
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Poster Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Back

Late-Breaking Abstract Presentations

Late-Breaking Abstract Presentations Session 2

(LB03) Single-dose intravenous iron versus oral iron for maternal iron deficiency anemia: a randomized controlled trial

Friday, January 31, 2025
10:00 AM – 10:15 AM  
Location: Aurora Ballroom, Lobby Level

    Coauthor(s)

  • RD

    Richard Derman

    Jefferson Health
    Philadelphia, PA, United States

  • MB

    Mrutyunjaya Bellad

    KLE Academy of Higher Education and Research’s J N Medical College,
    Belagavi, Karnataka, India

  • MS

    Manjunath Somannavar

    KLE Academy of Higher Education and Research’s J N Medical College,
    Belagavi, Karnataka, India

  • SB

    Sudhir Bhandari

    Sawai Man Singh Medical College
    Jaipur, Rajasthan, India

  • SM

    Sudhir Mehta

    Sawai Man Singh Medical College
    Jaipur, Rajasthan, India

  • SM

    Seema Mehta

    Sawai Man Singh Medical College
    Jaipur, Rajasthan, India

  • DS

    Dharmesh Sharma

    Sawai Man Singh Medical College
    Jaipur, Rajasthan, India

  • YK

    Yogesh Kumar

    KLE Academy of Higher Education and Research’s J N Medical College,
    KLE Academy of Higher Education and Research’s J N Medical College,, Karnataka, India

  • UC

    Umesh Charantimath

    KLE Academy of Higher Education and Research’s J N Medical College,
    KLE Academy of Higher Education and Research’s J N Medical College,, Karnataka, India

  • AP

    Amaresh Patil

    KLE Academy of Higher Education and Research’s J N Medical College
    Belagavi, Karnataka, India

  • AM

    Ashalata Mallapur

    S Nijalingappa Medical and HSK Hospital and Research Center
    Bagalkote, Karnataka, India

  • UR

    Umesh Ramdurg

    S Nijalingappa Medical and HSK Hospital and Research Center
    Bagalkote, Karnataka, India

  • RS

    Radha Sangavi

    Raichur Institute of Medical Sciences
    Raichur, Karnataka, India

  • PP

    Praveen Patil

    Raichur Institute of Medical Sciences
    Raichur, Karnataka, India

  • SR

    Subarana Roy

    ICMR – National Institute of Traditional Medicine
    Belagavi, Karnataka, India

  • PV

    Phaniraj Vastrad

    Model Rural Health Research Unit
    Sirwar, Karnataka, India

  • CS

    Chander Shekhar

    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

  • BL

    Benjamin Leiby

    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

  • RH

    Rebecca Hartman

    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

  • MG

    Michael Georgieff

    University of Minnesota
    Minneapolis, Minnesota, United States

  • SM

    Stephen Mennemeyer

    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

  • ZA

    Zubair H. Aghai, MD

    Sidney Kimmel Medical College at Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

  • ST

    Simal Thind

    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

    • Submitting Author and Presenting Author(s)

  • Rupsa C. Boelig, MD (she/her/hers)

    Associate Professor
    Sidney Kimmel Medical College, Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

Objective: Maternal iron deficiency anaemia (IDA) is a persistent global health challenge with increased risk of adverse perinatal outcomes. Obstetric guidelines recommend first line treatment with oral iron, however rates of maternal IDA remain above global targets. We aimed to determine whether single dose intravenous (IV) iron for maternal IDA in the 2nd trimester was superior to oral iron in reducing incidence of low birth weight (LBW) infants and maternal anemia at delivery.

Study Design: This is a parallel, three-arm superiority randomized controlled multi-center trial in India of pregnant singletons at 14-17 weeks with moderate IDA randomized to: (1) 60mg oral ferrous sulphate twice daily; or single dose infusion of (2) intravenous (IV) ferric derisomaltose (FDM) or (3) IV ferric carboxymaltose (FCM). The dual primary outcomes were: (1) LBW ( < 2500 grams [g]) and (2) maternal non-anemic state (NAS) (Hb >11·0 g/dL at 30-34 weeks or delivery). Participants received rescue treatment per local clinical care guidelines (Hb < 7g/dL or < 1g/dL improvement in Hb). Sensitivity analysis performed defining NAS as Hb≥11.0 without additional non-study iron or blood transfusion.

Results: The oral iron, FDM, and FCM arms included 1450, 1456, and 1462 participants respectively. There was a reduced rate of LBW with IV FCM (25·2%, Relative Risk [RR] 0·87 [97·55% CI 0·75,0·99]), but not IV FDM (29·1%, RR 0·98 [97·55% CI 0·86,1·12]) vs oral iron (Fig1). Achievement of NAS was not improved: IV FCM (RR 1·05 [99·95% CI 0·97-1·15]) and IV FDM (RR 1·06 [99·95% CI 0·98, 1·16]) vs oral (Fig 1, 2A). In sensitivity analysis, there was increased rate of NAS in both IV FDM (RR 1.25 (1.13-1.396), p< 0.0001) and IV FCM (RR 1.24 (1.12-1.38), p< 0.0001) vs oral (Fig 2C).

Conclusion: First-line treatment of maternal IDA with single dose infusion of IV iron results in a reduced incidence of LBW infants (IV FCM) and higher incidence of maternal NAS without additional iron or blood transfusion (IV FCM and FDM).
Clinical guidelines should address the potential benefit of single dose IV iron as the primary treatment of IDA in pregnancy.