Maintaining Normal Serum Ferritin Levels During Pregnancy: A Randomized Controlled Trial of Daily versus Weekly Ferrous Sulfate

Abstract

Background: Serum ferritin is the most reliable indication of stored iron in pregnancy, offering a noninvasive way to detect iron deficiency anemia before it occurs. Therefore, this study aimed to determine serum ferritin levels among women receiving daily versus weekly iron supplementation, with a secondary focus on comparing the proportion developing iron deficiency anemia and compli-ance rates between the two groups.Methods: This non-blinded randomized control trial involved non-anaemic pregnant women attend-ing antenatal clinics at two Teaching Hospitals in Osun State. One hundred twenty-five subjects were recruited to receive 65mg in the control group, while another 125 subjects in the active group re-ceived three tablets (195mg) of ferrous sulfate (Fesulf) once weekly for 17 weeks from the 20th to 37th weeks of gestation. The primary outcome measure was comparing mean serum ferritin levels in both groups at 37 weeks.Results: Among the 240 subjects analyzed, the 37-week serum ferritin level was higher in the daily group (73.26±26.67μg/L) compared to the weekly group (63.04±30.71 μg/L), p value=0.006. Four (3.36%) and 10 (8.26%) of our subjects had Iron deficiency anaemia. Nine subjects (3.75%) reported dyspepsia as a side effect. Daily 65 mg of Felsulf proved more effective than weekly 195mg in main-taining normal blood ferritin levels during pregnancy.Conclusions: Daily iron supplementation with 65mg ferrous sulfate was more effective at main-taining adequate maternal iron concentration in this group of non-anaemic pregnant women. This dosage is recommended for routine iron supplementation in our environment.