Objective: To compare the effects of oral ferrous bisglycinate 25 mg iron/day vs. ferrous sulfate 50 mg iron/day in the prevention of iron deficiency (ID) and iron deficiency anemia (IDA) in pregnant women. Design: Randomized, double-blind, intention-to-treat study. Setting: Antenatal care clinic. Sample: 80 healthy ethnic Danish pregnant women.
Methods: Women were allocated to ferrous bisglycinate 25 mg elemental iron (Aminojern®) (n=40) or ferrous sulfate 50 mg elemental iron (n=40) from 15 to 19 weeks of gestation to delivery. Hematological status (hemoglobin, red blood cell indices) and iron status (plasma iron, plasma transferrin, plasma transferrin saturation, plasma ferritin) were measured at 15–19 weeks (baseline), 27–28 weeks and 36–37 weeks of gestation. Main outcome measures: Occurrence of ID (ferritin <15 μg/L) and IDA (ferritin <12 μg/L and hemoglobin <110 g/L).
Results: At inclusion, there were no significant differences between the bisglycinate and sulfate group concerning hematological status and iron status. The frequencies of ID and IDA were low and not significantly different in the two iron groups. The frequency of gastrointestinal complaints was lower in the bisglycinate than in the sulfate group (P=0.001). Newborns weight was slightly higher in the bisglycinate vs. the sulfate group (3601±517 g vs. 3395±426 g, P=0.09).
Conclusions: In the prevention of ID and IDA, ferrous bisglycinate was not inferior to ferrous sulfate. Ferrous bisglycinate in a low dose of 25 mg iron/day appears to be adequate to prevent IDA in more than 95% of Danish women during pregnancy and postpartum.
Background/objectives: To assess vitamin D status during normal pregnancy and in the postpartum lactation period.
Subjects/methods: The study comprised 141 healthy, ethnic Danish women with normal pregnancies, who were residents in Greater Copenhagen. Serum 25-hydroxy-vitamin D2+D3(25-OH-vitamin D) was measured at 18, 32 and 39 weeks’ gestation and 8 weeks postpartum.
Results: There was a significant increase in 25-OH-vitamin D from 18 to 32 weeks’ gestation (P=0.0001) followed by a significant decrease from 32 to 39 weeks (P=0.001) as well as from 39 weeks to 8 weeks postpartum (P<0.0001). At 18, 32, 39 weeks’ gestation and 8 weeks postpartum, median 25-OH-vitamin D values were 77, 98, 91, and 73 nmol/L, respectively. During pregnancy and postpartum, none of the women displayed severe vitamin D deficiency (values <13 nmol/L). Between 1.4% and 4.3% of the participants displayed moderate vitamin D deficiency (values 13–24 nmol/L), 16–19% displayed vitamin D insufficiency (values 25–50 nmol/L), 77–84% had values >50 nmol/L and 0.7–2.8% had values >200 nmol/L.
Conclusions: Low vitamin D status is frequent among pregnant Danish women, especially in late pregnancy and during lactation. Median dietary intake of vitamin D in women of reproductive age was 2.4 μg/day (10–90 percentile range=1.4–5.0). The recommendations for vitamin D supplementation prior to conception, during pregnancy and lactation should be reconsidered.
To compare the efficacy and safety of intravenous ferric carboxymaltose (FCM) with first-line oral ferrous sulfate (FS) in pregnant women with iron deficiency anemia (IDA).
Materials and methods:
Pregnant women (n=252; gestational weeks 16–33) with IDA were randomized 1:1 to FCM (1000–1500 mg iron) or FS (200 mg iron/day) for 12 weeks. The primary objective was to compare efficacy; secondary objectives included safety and quality of life.
Hemoglobin (Hb) levels improved at comparable rates across both treatments; however, significantly more women achieved anemia correction with FCM vs. FS [Hb ≥11.0 g/dL; 84% vs. 70%; odds ratio (OR): 2.06, 95% confidence interval (CI): 1.07, 3.97; P=0.031] and within a shorter time frame (median 3.4 vs. 4.3 weeks). FCM treatment significantly improved vitality (P=0.025) and social functioning (P=0.049) prior to delivery. Treatment-related adverse events were experienced by 14 (FCM; 11%) and 19 (FS; 15%) women, with markedly higher rates of gastrointestinal disorders reported with FS (16 women) than with FCM (3 women). Newborn characteristics were similar across treatments.
During late-stage pregnancy, FCM may be a more appropriate option than first-line oral iron for rapid and effective anemia correction, with additional benefits for vitality and social functioning.