A COMPARATIVE STUDY OF FERROUS ASCORBATE AND FERROUS FUMARATE IN TREATING IRON DEFICIENCY ANEMIA DURING PREGNANCY: EFFICACY AND SAFETY ANALYSIS

Background: Iron deficiency anemia (IDA) is a common condition among pregnant women, adversely affecting maternal and fetal health. Oral iron supplements such as ferrous ascorbate and ferrous fumarate are commonly prescribed, yet comparative studies evaluating their efficacy, safety, and cost-effectiveness are limited. Objective: To compare the efficacy, safety, and cost-effectiveness of ferrous ascorbate and ferrous fumarate in pregnant women diagnosed with iron deficiency anemia. Methods: This prospective observational study included 118 pregnant women recruited from the In-Patient and Out-Patient facilities of the Department of Obstetrics and Gynecology, King George Hospital, Visakhapatnam. Participants were divided into two equal groups: Group A received ferrous ascorbate (n=59) and Group B received ferrous fumarate (n=59). Baseline demographic, clinical, and laboratory parameters were recorded, including hemoglobin (Hb), red blood cell (RBC) count, hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW-CV). Follow-up assessments were conducted after 60 days of supplementation. Adverse effects and cost-effectiveness were also evaluated. Results: The majority of participants were aged 21–25 years (44.9%), multigravida (77.9%), and urban residents (56.8%). Most subjects were mildly anemic (69.5%). After 60 days, Group A showed a greater mean increase in Hb (9.74 → 11.49 g/dL) compared to Group B (10.43 → 11.36 g/dL). Similar trends were observed for RBC count, Hct, MCV, MCH, and MCHC. RDW-CV decreased in both groups. Minor gastrointestinal side effects were reported in 11 subjects in Group A and 7 subjects in Group B, with no hypersensitivity reactions observed. The average cost-effectiveness per 1% rise in Hb was Rs. 58.87 for Group A and Rs. 50.72 for Group B. Conclusion: Ferrous ascorbate demonstrated superior improvement in hematological parameters with comparable safety and slightly higher cost-effectiveness compared to ferrous fumarate in pregnant women with iron deficiency anemia. These findings suggest ferrous ascorbate as an effective and safe option for managing IDA during pregnancy. Keywords: Iron deficiency anemia, pregnancy, ferrous ascorbate, ferrous fumarate, efficacy, safety, cost-effectiveness.