Amino Acid Chelated Iron versus Ferrous Fumarate in the Treatment of Iron Deficiency Anemia with Pregnancy : Randomized Controlled Trial

Background: Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. Suboptimal iron content in the average mother's diet and the presence of insufficient iron stores during the reproductive years are causes for this predominance. In many developing countries, iron deficiency anemia (IDA) in pregnancy is more of a rule than an exception with a prevalence of 52%. In the Western societies, the frequency of IDA is approximately 25% in pregnant women not taking iron supplements and less than 5% in women taking iron supplements. Anemia has a significant impact on the health of the fetus and the mother. It can be associated with increased preterm labour, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths.Aim: To find out whether there is a difference between amino acid chelated iron and iron salts (ferrous fumarate) in effect, safety, adverse effects and outcomes in treatment of iron deficiency anemia during pregnancy.Patients and Methods: The study was conducted on pregnant women attending the antenatal care in the outpatient clinic at Ain-Shams University Maternity Hospital in the period from February 2019 to July 2019, with diagnosis of iron deficiency anemia between 14 -18 weeks with hemoglobin (HB) level 8–10.5g/dL, and serum ferritin <15μg/l. One hundred fifty pregnant women who met the criteria were randomized in to 2 groups (iron chelated amino acid "IAAC" group and ferrous fumarate "FF" group). Hemoglobin level, blood indices, serum iron and serum ferritin levels were measured in both groups at 4, 8, 12 weeks of treatment.Results: There was a significant hematological improvement (mean HB level, blood indices, serum iron and ferritin levels) in both groups which was significantly higher in IAAC group.Conclusion: Iron amino acid chelate achieves faster cure rate than ferrous fumarate in women with iron deficiency anemia in pregnancy as regards mean HB and serum ferritin level. Iron amino acid chelate is associated with fewer side effects than ferrous fumarate.