Daily Versus Alternate-Day Oral Iron Therapy for Anemia in Second-Trimester Pregnancy

This randomized controlled trial compares daily versus alternate-day oral iron supplementation in pregnant women with iron deficiency anemia during the second trimester. The study evaluates changes in hemoglobin and serum ferritin, treatment adherence, and gastrointestinal side effects to inform more patient-centered, physiologically aligned dosing strategies.

Inclusion Criteria: * Aged 18 to 40 years * Pregnant women in the second trimester (13 to 27 weeks gestation) * Hemoglobin below 11 g/dL with serum ferritin below 30 ng/mL * Singleton pregnancy Exclusion Criteria: * Known congenital or acquired hemoglobin disorders (e.g., thalassemia, hemoglobinopathies) * Chronic diseases affecting hemoglobin levels (e.g., chronic kidney disease, inflammatory disorders) * Bleeding disorders or a history of frequent blood loss * Gastrointestinal conditions impairing nutrient absorption (e.g., celiac disease or other malabsorption syndromes) * Currently receiving parenteral iron * Requiring blood transfusion