Heme-bound iron (Optifer) versus intravenous iron (Ferosac) in treatment of pregnancy associated iron deficiency anemia

This comparative study designed to compare the efficacy and tolerability of the heme-bound iron Optifer (HIO) versus iron saccharate complex (Ferosac) in treatment of pregnancy associated iron deficiency anemia. Studied women will receive either heme-bound iron Optifer (HIO) tablets (Per Oral (PO) group) or intravenous iron saccharate (Ferosac), (Intravenous (IV) group) for correction of pregnancy associated iron deficiency anemia. The Optifer tablets contain 18 mg heme-bound iron. Each tablet of Optifer increases the serum iron by 3.15 mg and women in the Optifer group will receive two tablets twice daily 1 tablet morning and 1 tablet evening (according to manufacturer instructions) for at least equal or more than 3 months. Women in the intravenous group will receive the calculated intravenous iron dose according to the formula; total iron needed in mg = 2.4 × pre-pregnancy weight in kg × (target hemoglobin concentration - actual hemoglobin concentration) gm/dl + 500 mg. Twelve (12) gm/dl is the target hemoglobin concentration and 2.4 is a correction factor, while the 500 is the amount of stored iron in adult pregnant women. The calculated total intravenous iron dose will be given over 6-8 sessions, in each session 200 mg of iron saccharate complex will be diluted in normal saline and given by intravenous infusion over one hour every other day. The adherence to the intervention will be checked by the empty tablets package in the oral group and by the hospital admission records in the intravenous group. The adherence to treatment in intravenous group will be checked by the hospital admission records. This study is non-randomized study; the first half of enrolled women will receive oral iron Optifer and the second half of enrolled women will receive intravenous iron. In addition; women who will develop intolerance or gastric upset to oral iron Optifer will shifted to intravenous iron preparation.