Background: Iron deficiency anemia (IDA) is one of the most common medical disorder disturbing
pregnancies particularly in low resources countries, and contributes significantly to morbidities
and mortalities. Thus, early diagnosis and prompt management of IDA is highly
recommended.
Aim: To Test the efficacy and safety of oral lactoferrin plus health education provided by a nurse
versus total dose infusion (TDI) of low-molecular weight (LMW) iron dextran for treating IDA in
the second and third trimester of pregnancy.
Design: A prospective interventional, randomized, parallel-group, single-center longitudinal
study.
Setting: Woman’s Health Assiut University Hospital, Assiut, Egypt, at the outpatient clinic and
inpatient unit. It comprised 120 cases divided into two groups as pineapple flavored lactoferrin
oral sachets 100mg twice daily with health education (group A) and TDI of LMW iron dextran
(group B).
Main outcome measures: The primary efficacy parameter was clinical improvement and the
amount of increase in hemoglobin concentration by 4 weeks after therapy, secondary outcome
measures included measurement of the rest of RBC, and iron indices, the adverse effects related
to iron therapy and the patient compliance to the treatment.
Results: There was insignificant difference between both groups regarding sociodemographic
data, parity and mean gestational age. Both groups showed a significant clinical improvement of
anemia 4 weeks post-therapy. There was no statistically significant difference in mean Hb
level improvement in both groups after 1 month of therapy. However, mean corpuscular
volume (MCV) and mean corpuscular hemoglobin (MCH) improved significantly more in group B
than A while iron indices (serum iron and serum ferritin) were significantly more in group A
than group B.
Conclusions: Pineapple flavored lactoferrin oral sachets plus health education can be widely
used as an alternative to TDI iron dextran supplementation due to clinical as well as laboratory
improvement of IDA during pregnancy after 1 month of treatment. Proper health education of
the pregnant women with nurse recommendations of balanced diet containing good sources of
iron would increase awareness of pregnant women and help eradicate IDA with its serious
sequel during pregnancy.