Comparing the treatment outcomes of oral and injectable iron therapies for anemia in pregnancy: a meta-analysis
Qayyum, Junaid Farhan, Syeda Quratulain Qureshi, Qurat Ul Ain Jamali, Ayesha Ghazal Fatima, Arooj Imtiaz, Bushra Alharbi, Noor M Partab, Fnu Shweta, Fnu Kumar, Varsha
Qayyum, Junaid
Farhan, Syeda Quratulain
Qureshi, Qurat Ul Ain
Jamali, Ayesha Ghazal
Fatima, Arooj
Imtiaz, Bushra
Alharbi, Noor M
Partab, Fnu
Shweta, Fnu
Kumar, Varsha
Affiliation
University Hospitals Birmingham NHS Foundation Trust; University Hospitals Coventry and Warwickshire; Liaquat University of Medical and Health Sciences; Type-D Hospital; Qasmi Eye and Gynae Hospital; University of Ha'il; Chandka Medical College; Drexel University; Hamza Medicare Hospital
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Publication date
2025-02-01
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Abstract
Iron deficiency anemia (IDA) during pregnancy is a global public health concern, associated with significant maternal and neonatal complications. Intravenous (IV) iron therapy has emerged as a potential alternative to oral iron for rapid correction of anemia, but its impact on clinical outcomes remains unclear. This meta-analysis aimed to evaluate the effectiveness and safety of IV iron compared to oral iron in improving maternal and neonatal outcomes during pregnancy. A systematic review of randomized controlled trials (RCTs) was conducted using major databases. A total of 15 studies, involving 4,215 pregnant women, met the inclusion criteria. Meta-analyses were performed to assess maternal and neonatal complications, adverse events, and hemoglobin (Hb) improvement. The findings demonstrated that IV iron therapy significantly improved Hb levels more rapidly than oral iron, with a mean rise of 2.05 g/dL for IV iron compared to 1.65 g/dL for oral iron. Women receiving IV iron experienced 21% fewer maternal complications, although the difference was not statistically significant for individual complications. Neonatal outcomes, including birth weight, cord Hb levels, and preterm births, showed no significant differences between the two groups. Adverse events were significantly less frequent in the IV group (OR 0.38; 95% CI: 0.24-0.58; p < 0.01), indicating a better safety profile. This study highlights the superior efficacy of IV iron for rapid anemia correction and reduced adverse events in pregnant women. However, no significant advantage was observed for neonatal outcomes or individual maternal complications. The evidence quality for Hb improvement was high, while that for maternal and neonatal clinical outcomes varied from moderate to low. Further research is needed to explore the impact of IV iron on critical clinical outcomes and to determine the most cost-effective regimens for anemia management during pregnancy.
Citation
Qayyum J, Farhan SQ, Qureshi QUA, Jamali AG, Fatima A, Imtiaz B, Alharbi NM, Partab F, Shweta F, Kumar V. Comparing the Treatment Outcomes of Oral and Injectable Iron Therapies for Anemia in Pregnancy: A Meta-Analysis. Cureus. 2025 Feb 1;17(2):e78326. doi: 10.7759/cureus.78326.
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Article