Oral administration of lactoferrin increases hemoglobin and total serum iron in pregnant women. Lactoferrin Efficacy versus Ferrous Sulfate in Curing Iron Disorders in Pregnant and Non-Pregnant Women Lactoferrin versus ferrous sulphate for the treatment of iron deficiency anemia during pregnancy: a randomized clinical trial Efficacy and tolerability of oral bovine lactoferrin compared to ferrous sulfate in pregnant women with iron deficiency anemia: A prospective controlled randomized study Safety and efficacy of lactoferrin versus ferrous sulphate in curing iron deficiency and iron deficiency anaemia in hereditary thrombophilia pregnant women: an interventional study Efficacy of daily vs. weekly supplementation of iron in schoolchildren with low iron status. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women. Iron Sucrose Versus Oral Iron Therapy in Pregnancy Anemia Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy.
Iron deficiency anemia ( IDA ) during pregnancy continues to be of world-wide concern . IDA is a risk factor for preterm delivery and subsequent low birth weight , and possibly for poor neonatal health . Iron supplementation in pregnancy is a widely recommended practice , yet intervention programs have met with many controversies . In our study , 300 women at different trimesters of pregnancy were enrolled in a trial of oral administration of ferrous sulfate ( 520 mg once a day ) or 30 % iron-saturated bovine lactoferrin ( bLf ) ( 100 mg twice a day ) . Pregnant women refusing treatment represented the control group . In this group hemoglobin and total serum iron values measured after 30 d without treatment decreased significantly , especially in women at 18 - 31 weeks of pregnancy . In contrast , after 30 d of oral administration of bLf , hemoglobin and total serum iron values increased and to a greater extent than those observed in women treated orally for 30 d with ferrous sulfate , independently of the trimester of pregnancy . Unlike ferrous sulfate , bLf did not result in any side effects . These findings lead us to hypothesize that lactoferrin could influence iron homeostasis directly or through other proteins involved in iron transport out of the intestinal cells into the blood Iron homeostasis in pregnancy compensates for increased iron requirements and in women of child-bearing age for iron loss in menses . Oral administration of ferrous sulfate , prescribed to cure iron deficiency ( ID ) and ID anemia ( IDA ) , often fails to increase hematological parameters and causes adverse effects . Recently , we demonstrated safety and efficacy of bovine lactoferrin ( bLf ) in pregnant women suffering from ID/IDA . Two clinical trials were conducted on pregnant and non-pregnant women of child-bearing age suffering from ID/IDA . In both trials , women received oral administration of bLf 100 mg/twice/day ( Arm A ) , or ferrous sulfate 520 mg/day ( Arm B ) . Hematological parameters , serum IL-6 and prohepcidin were assayed before and after therapy . Unlike ferrous sulfate , bLf  increased hematological parameters ( P<0.0001 ) . In pregnant women , bLf  decreased serum IL-6 ( P<0.0001 ) , and increased prohepcidin ( P=0.0007 ) . In non-pregnant women bLf did not change the low IL-6 levels while it increased prohepcidin ( P<0.0001 ) . Ferrous sulfate increased IL-6 ( P<0.0001 ) and decreased prohepcidin ( P=0.093 ) . bLf established iron homeostasis by modulating serum IL-6 and prohepcidin synthesis , whereas ferrous sulfate increased IL-6 and failed to increase hematological parameters and prohepcidin .  bLf is a more effective and safer alternative than ferrous sulfate for treating ID and IDA Abstract Objective : This study was conducted to evaluate the efficacy and safety of lactoferrin in comparison to ferrous sulphate for the treatment of iron deficiency anemia ( IDA ) during pregnancy . Material s and methods : This prospect i ve , r and omized , parallel-group , single-center study was conducted in the Department of Obstetrics and Gynecology at Menoufia University Hospital , Egypt and included a total of 200 pregnant women in the second trimester with IDA who were enrolled and r and omly assigned either to receive 150 mg of dried ferrous sulphate capsules or lactoferrin 250 mg capsules once daily for eight consecutive weeks . The primary efficacy parameter was the amount of increase in hemoglobin concentration by 4 and 8 weeks , the adverse effects related to iron therapy and the patient compliance to the treatment . Results : Total increase in Hb after 2 months with lactoferrin was higher ( 2.26 ± 0.51 g/dL ) compared to ferrous sulfate ( 1.11 ± 0.22 g/dL ) ( p < 0.001 ) . Gastrointestinal adverse events occurred more frequently with ferrous sulphate than the lactoferrin group ( p < 0.001 ) . The number of women requesting change the drug was higher in the ferrous sulphate group ( p < 0.001 ) . Conclusion : Lactoferrin was more effective than ferrous sulfate over a two-month period in pregnant women with IDA , with fewer gastrointestinal adverse events and better treatment acceptability Objective . To compare the effects of bovine lactoferrin with ferrous sulfate on iron nutritional status and to evaluate their tolerability in 100 pregnant women with iron deficiency anemia . Design . Prospect i ve , r and omized , controlled , double blind trial . Setting . Obstetrics clinic of a University Department of Obstetrics and Gynecology . Population . One‐hundred pregnant , healthy women to be treated either with one capsule of 100 mg bovine lactoferrin twice a day ( Group A ; n = 49 ) and 520 mg ferrous sulfate once a day ( Group B ; n = 48 ) . Methods . After 30 days , we evaluated hemoglobin ( Hb ) , serum ferritin , serum iron and total iron‐ binding capacity ( TIBC ) values . All women were asked to keep a diary of five potential gastrointestinal side effects ( abdominal pain , nausea , vomiting , diarrhea and constipation ) . For each symptom , patients had to rate its severity according to a scale ranging from 0 ( absent ) to 3 ( severe ) . Main outcome measures . Hb level before and after treatment . Secondary outcomes were serum ferritin , serum iron and TIBC levels and the difference in symptom scores between groups . Results . In Groups A and B , Hb , serum ferritin and iron were significantly increased while TIBC was significantly reduced in comparison with basal values . No significant differences were observed between Groups A and B. The median scores of abdominal pain and constipation were significantly higher in patients treated with ferrous sulfate in comparison with those treated with bovine lactoferrin . Conclusions . The results show that bovine lactoferrin has the same efficacy as ferrous sulfate in restoring iron deposits with significantly fewer gastrointestinal side effects Objective Evaluate the safety and efficacy of bovine lactoferrin ( bLf ) versus the ferrous sulphate st and ard intervention in curing iron deficiency ( ID ) and ID anaemia ( IDA ) in pregnant women affected by hereditary thrombophilia ( HT ) . Design Interventional study . Setting Secondary -level hospital for complicated pregnancies in Rome , Italy . Population 295 HT pregnant women ( ≥18 years ) suffering from ID/IDA . Methods Women were enrolled in Arm A or B in accordance with their personal choice . In Arm A , 156 women received oral administration of 100 mg of bLf twice a day ; in Arm B , 139 women received 520 mg of ferrous sulphate once a day . Therapies lasted until delivery . Main outcome measures Red blood cells , haemoglobin , total serum iron , serum ferritin ( haematological parameters ) were assayed before and every 30 days during therapy until delivery . Serum IL-6 , key factor in inflammatory and iron homeostasis disorders , was detected at enrolment and after therapy at delivery . Possible maternal , foetal , and neonatal adverse effects were assessed . Results Haematological parameters were significantly higher in Arm A than in Arm B pregnant women ( P ≤ 0.0001 ) . Serum IL-6 significantly decreased in bLf-treated women and increased in ferrous sulphate-treated women . BLf did not exert any adverse effect . Adverse effects in 16.5 % of ferrous sulphate-treated women were recorded . Arm A women experienced no miscarriage compared to five miscarriages in Arm B women . Conclusions Differently from ferrous sulphate , bLf is safe and effective in curing ID/IDA associated with a consistent decrease of serum IL-6 . The absence of miscarriage  among bLf-treated women provided an unexpected benefit . Trial registration : Clinical Trials.gov Identifier NCT01221844 Iron deficiency anemia ( IDA ) is still a major nutritional and public health problem in developing countries . The prevalence among young children and pregnant women is particularly high . Daily oral supplementation with medicinal iron is considered an effective strategy for reducing the incidence of IDA but non-compliance is a major problem with this strategy . We undertook this study to compare the results of once-weekly vs. daily oral iron supplementation in schoolchildren . Sixty children ranging between 5 and 10 years with iron deficiency anemia were selected from a school in Karachi , Pakistan and were divided into two equal groups , i.e. , daily and weekly supplementation groups . Hemoglobin ( Hb ) , hematocrit ( Hct ) , serum iron , total iron binding capacity ( TIBC ) , and serum ferritin were determined before the start of the study . Ferrous sulfate ( 200 mg ) was given daily to the daily supplementation group and once-weekly to the weekly supplementation group for 2 months . When post-supplementation values of the above-mentioned parameters were determined , a significant improvement was observed in all parameters in both groups . It is concluded that once-weekly iron supplementation is as effective as daily supplementation for the treatment of iron deficiency anemia . Moreover , weekly iron supplementation is cost effective and has no or fewer side-effects Abstract 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 : R and omized , 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 The efficacy of iron polymaltose complex ( IPC ) in the treatment of iron deficiency anemia ( IDA ) during pregnancy has not been well established , and the evidence is inconclusive . AIMS The aim of the study was to compare efficacy , safety , compliance , and cost-effectiveness of IPC with ferrous sulphate ( FS ) in pregnant patients . SETTING S AND DESIGN S The r and omized , double-blind , parallel-group study was conducted in the Department of Pharmacology in collaboration with the Department of Obstetrics and Gynaecology Postgraduate Institute of Medical Education and Research , Ch and igarh , India . METHODS One hundred pregnant women aged 20 - 40 years at 14 to 27 weeks ' gestation , with hemoglobin ( Hb ) < 9 g/dL , and serum ferritin < 12 mcg/L , were classified into 2 groups . One group received IPC ( 100 mg elemental iron ) , and the other group received FS ( 120 mg elemental iron ) daily for 8 weeks . At Week 0 and Week 8 , Hb , packed cell volume ( PCV ) , mean corpuscular volume ( MCV ) , mean corpuscular hemoglobin ( MCH ) , mean corpuscular hemoglobin concentration ( MCHC ) , serum iron , and serum ferritin were measured . Compliance with study medication was determined by pill counting at each visit . Cost minimization analysis was done to compare the costs of the 2 treatments . STATISTICAL ANALYSIS Data are expressed as mean -/+ SD . Paired and unpaired ' t ' test were used to analyze differences within groups and between groups . Chi-square ( x2 ) test was used to analyze primary efficacy parameters and adverse drug reactions ( ADR ) . RESULTS Statistically significant increases in Hb , PCV , MCV , MCH , MCHC , serum iron , and serum ferritin levels were seen at the end of 8 weeks of treatment in both groups . The overall adverse effects were more common in the FS group compared with the IPC group [ 41 ( 78 % ) vs 15 ( 31 % ) , P < .001 ] . The compliance rate was significantly ( P < .05 ) higher for the IPC ( 91 % ) group than for the FS ( 87 % ) group . The average total cost ( direct + indirect ) of treatment of anemia was comparable between the 2 groups . CONCLUSION The results of the present study suggest that IPC can be considered as a useful alternative formulation for the treatment of IDA during pregnancy for those patients who can not tolerate other iron preparations ( ferrous form ) ; this is an important finding , as compliance is a significant concern during pregnancy Background : Iron deficiency anemia ( IDA ) is the most common medical problem in pregnancy .  Parenteral iron is a useful treatment , although iron dextran use decreased due to anaphylaxis . Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran . Objective : The aim of this study was to compare the efficacy and tolerance of intravenous iron sucrose ( IVIS ) therapy with oral iron ( OI ) therapy in pregnant women with IDA and to study the factors influencing treatment . Material s and Methods : This prospect i ve , r and omized clinical trial included pregnant women between 14 and 36 weeks with established IDA who were treated with IVIS or OI ( ferrous fumarate ) .  All patients were monitored for laboratory response and adverse effects . Independent sample -t test , Chi square test and ANOVA were used for statistical analysis . P < 0.05 was considered significant . Results : Although hemoglobin increased in both the groups , increase in the reticulocyte count and percentage increase in hemoglobin was significantly higher in the IVIS group than in the OI group ( 23.62 % vs. 14.11 % ) . Serum ferritin was significantly higher in the IVIS group than in the OI group ( P = 0.000 ) . The IVIS group had no major side-effects . Compliance was good with OI , although 23 % had gastrointestinal side-effects . Patient weight , gestation at diagnosis , initial hemoglobin and ferritin levels did not influence the response to treatment . Conclusion : IVIS is safe and effective in the treatment of IDA during pregnancy . Iron stores increased better with IVIS compared with OI OBJECTIVE To evaluate the safety and efficacy of intravenous iron sucrose complex ( ISC ) as compared with oral ferrous sulfate in the treatment of iron deficiency anemia during pregnancy . STUDY DESIGN prospect i ve , open , controlled study in which pregnant women with iron deficiency anemia were sequentially selected from the antenatal clinic and assigned either to ISC ( study group ) or to ferrous sulfate ( control group ) . METHODS Each study patient was given the total calculated amount of ICS ( Hb deficit ( g/l ) x body weight ( kg ) x 0.3 ) in divided doses ( 200 mg ( elemental iron ) in 100 ml normal saline intravenously over 1 h daily ) followed by 10 mg/kg to replenish iron stores . Each patient of the control group was given ferrous sulfate 300 mg ( 60 mg elemental iron ) orally three times a day . All patients were monitored for adverse effects , clinical and laboratory response . RESULTS There were 52 patients and 59 controls . ISC group achieved a significantly higher Hb level ( 128.5 + /- 6.6 g/l vs. 111.4 + /- 12.4 g/l in the control group P < or = 0.001 ) in a shorter period ( 6.9 + /- 1.8 weeks vs. 14.9 + /- 3.1 weeks in the control group , P < or = 0.001 ) . ISC complex group showed no major side effects while 4 ( 6 % ) of the control group could not tolerate ferrous sulfate , 18 ( 30 % ) complained of disturbing gastrointestinal symptoms and 18 ( 30 % ) had poor compliance . CONCLUSION We conclude that ISC is safe and effective in the treatment of iron deficiency anemia during pregnancy
Significantly less gastrointestinal side effects were reported with lactoferrin treatment .
No significant differences existed with regard to other outcomes .
In conclusion , for pregnant women with IDA , daily oral bovine lactoferrin is just as good as ferrous sulfate in improving hematological parameters with fewer gastrointestinal side effects .
This systematic review and meta- analysis aim ed to evaluate the efficacy of daily oral bovine lactoferrin versus daily oral ferrous iron preparations for treatment of iron deficiency anemia ( IDA ) during pregnancy .