The Effectiveness of Single Versus Double Daily Dose of Oral Ferrous Bisglycinate on the Prevention of Iron Deficiency Anemia in Obese Non-Anemic Pregnant Women: A Randomized Clinical Trial

Objective: To compare the effectiveness of 27 mg versus 54 mg oral ferrous bisglycinate on the prevention of iron deficiency anemia (IDA) in obese non-anemic pregnant womenMaterial and Methods: The study was a randomized clinical trial conducted from October 2019 to April 2022 at Assiut Woman's Health Hospital, Egypt included obese non-anemic pregnant women in the first trimester. The eligible women were randomized to 27 mg (group I) or 54 mg (group II) of oral ferrous bisglycinate taken daily until delivery. The primary outcome was the number of anemic women at the time of delivery. The level of serum hepcidin at 36 weeks was another outcome. Data was analyzed using an unpaired t-test, the Mann–Whitney U test, and the Chi-square test.Results: Two hundred thirty women were divided equally into two groups. No statistically significant difference was observed between both groups in the number of anemic women at the time of delivery [15 women vs. 12 women; p= 0.445, respectively]. A significantly higher level of hepcidin was noted at 36 weeks in group II (30.1 ng/mL vs. 43.4 ng/mL; p=0.000, respectively). Other maternal and neonatal outcomes were comparable in both groups without statistically significant differences.Conclusion: Double daily dose of oral ferrous bisglycinate is not superior to single-dose in the prevention of IDA in obese non-anemic pregnant women when taken from the first trimester till delivery. Consideration should be given to increased hepcidin level with high prophylactic oral iron supplementation stressing the need for longer-term follow-up.