Effect of Daily Dose Vs Alternate Day Dose Oral Iron on Improvement in Hemoglobin Levels in Iron Deficiency Anemia in First and Second Trimester of Pregnancy

Sana Qayum; Bushra Rauf; Tahira Naz; Humera Gul; Nayab Gohar

doi:10.70749/ijbr.v3i5.1570

Authors

Sana Qayum Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Bushra Rauf Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Tahira Naz Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Humera Gul Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Nayab Gohar Hayatabad Medical Complex, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i5.1570

Keywords:

Iron Deficiency Anemia, Daily Iron Supplementation, Alternate-day Iron, Hemoglobin Increase

Abstract

Background: Iron deficiency anemia (IDA) is a common and significant complication during pregnancy, necessitating effective and well-tolerated treatment strategies. While daily oral iron supplementation is a standard approach, its comparative efficacy against alternate-day supplementation remains an area of ongoing research. Objective: To compare the efficacy of daily oral iron dose and alternate oral iron dose for the treatment of IDA in first and second trimester of pregnancy. Study Design: Randomized controlled trial. Duration and Place of Study: The study was conducted from May 2024 to November 2024 at the Obstetrics and Gynecology Department, Hayatabad Medical Complex, Peshawar. Methodology: A total of 296 pregnant women aged 15–40 years with singleton pregnancies (≤24 weeks gestation) and diagnosed with IDA were randomized into two groups. Group A received daily ferrous fumarate (350 mg) for eight weeks, while Group B received the same dose on alternate days. Weekly monitoring was performed, and hemoglobin levels were reassessed after eight weeks. Efficacy was defined as a hemoglobin increase of ≥2 g/dL. Results: In Group A, 28.4% of patients achieved the defined efficacy, compared to 13.5% in Group B (p=0.002). Stratification analyses revealed significant efficacy differences favoring Group A in patients aged 15–30 years (p=0.004), with gestational age ≤15 weeks (p=0.005), and BMI >25 (p=0.012). No significant differences were observed for older patients, later gestational age, or lower BMI categories. Conclusion: Daily oral iron supplementation is significantly more effective than alternate-day dosing in treating IDA during pregnancy, particularly in younger women.

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