Anemia Complicating Pregnancy

Anemia is a major public health problem among pregnant women, particularly in low- and middle-income countries. It is characterized by a reduction in hemoglobin concentration or the oxygen-carrying capacity of the blood, which may be insufficient to meet the physiological needs of the body. Maternal anemia is associated with an increased risk of adverse maternal and fetal outcomes. Despite the high prevalence of anemia among pregnant women, poor medication adherence and inadequate understanding of prescribed therapy may limit treatment effectiveness. Pharmacists can play an important role in providing medication-related education, improving patients' understanding of their treatment, identifying barriers to adherence, and promoting appropriate medication use. However, evidence on pharmacist-led educational interventions to improve medication adherence and hemoglobin levels among anemic pregnant women in Pakistan remains limited. Therefore, this randomized controlled trial will be conducted to evaluate the effect of a structured pharmacist-led educational intervention on medication adherence and hemoglobin levels among anemic pregnant women in District Chakwal, Punjab, Pakistan. A total of 100 eligible pregnant women diagnosed with anemia will be recruited and randomly allocated into intervention and control groups. Participants in the intervention group will receive a structured pharmacist-led educational intervention in addition to routine care, while participants in the control group will receive routine antenatal care and standard anemia management. Medication adherence and hemoglobin levels will be assessed at baseline and after the intervention. The study will determine whether pharmacist-led educational counseling improves medication adherence and hemoglobin levels compared with routine care. Data will be analyzed using IBM SPSS Statistics version 26. A paired-sample t-test will be used to compare changes in continuous variables, particularly hemoglobin levels, between baseline and post-intervention assessments. McNemar's test will be used to assess changes in paired categorical variables, including medication adherence where appropriate. A p-value of \<0.05 will be considered statistically significant.

This study aims to address this evidence gap by comparing a step-up oral-first strategy with an early IV iron strategy in pregnant women diagnosed with anemia after 34 weeks of gestation.

The goal of this prospective observational study is to examine the frequency of gastrointestinal side effects associated with oral iron supplementation during pregnancy. The main question it aims to answer is: Does intermittent oral iron supplementation result in fewer gastrointestinal side effects compared with daily supplementation in pregnant women? Pregnant women who are prescribed oral iron as part of their routine medical care will take ferrous sulfate on an alternate-day schedule for one week. If no significant gastrointestinal side effects are reported, they will then take ferrous sulfate daily for an additional week and will be followed for one month. Participants will be contacted by the study investigator to report gastrointestinal side effects, and routine blood tests will be used to assess changes in hemoglobin and iron stores.