Abstract: Background: Anemia is the most common medical disorder of pregnancy and carries significant maternal & fetal morbidity. Iron deficiency anemia is the commonest cause for this potentially preventable and treatable condition. A significant number of pregnant women need IV iron or blood transfusion during their late pregnancy despite having regular follow up and iron & folic acid supplementation. GI intolerance with oral iron therapy and subsequent poor drug compliance is the leading cause for this. This study designed to assess the efficacy of ferrous sulfate therapy, prevalence of GI intolerance and non – compliance with the treatment in a tertiary care Obstetrics Institute.
Methods: It is a prospective observational study. Eighty pregnant women with diagnosis of Iron deficiency anemia were included in this study. Ferrous sulfate 200mg with folic acid 500 tablets twice daily was given over 12 weeks. Parameters Hb, Hematocrit, Ferritin at baseline, at 6th week and 12th week measured. Six had lost follow up and seventy four women completed the study. Questionnaire to find out drug non – adherence applied. Adverse drug reactions noted. Rescue therapy in the form of IV iron or blood transfusion given whenever needed.
Results: Ferrous sulfate therapy significantly improved hemoglobin in 58% patients who compliant with the therapy. Eighty percent of patients experience GI intolerance. 42% of study population became non - compliant with drug and showed poor response to therapy. The difference in the hemoglobin improvement between compliant and non - compliant group was statistically significant (p < 0.001). Twenty five patients (34%) who received IV iron all from non – compliant group.
Conclusion: Oral iron in the form of ferrous sulfate is effective in the treatment of iron deficiency anemia during pregnancy. Newer formulations of oral iron with less GI side effects may be a better option in people experiencing gastro intestinal side effects to avoid IV iron or blood transfusion during pregnancy.
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