Although oral iron preparations are widely prescribed to prevent and to treat iron deficiency anemia in
pregnancy, comparative data on their effects to the mother, fetus and placenta are limited. In this study, the effects of oral
iron polymaltose complex (IPC), ferrous fumarate (FF) and ferrous sulfate (FS) were compared in anemic pregnant rats,
their fetuses and placentas. Hematological variables and oxidative stress markers in the liver, heart and kidneys of the
dams and fetuses as well as the markers for oxidative stress, inflammation and hypoxia in placentas were assessed.
Pregnancy outcome was measured by number of fetuses, and by neonate and placental weight. All therapies were
comparably effective in correcting anemia. FS and FF, but not IPC, resulted in liver damage in dams and oxidative stress
in dams, fetuses and placentas. FS group presented the highest catalase and GPx levels in dams, fetuses and placentas.
IPC, but not FF or FS, restored normal TNF-α and IL6 expression levels in placentas whereas FS-treated animals
presented the highest cytokine levels, suggesting a local inflammatory reaction. Anemia-induced high levels of HIF-1α
were partially lowered by IPC and FF but further elevated by FS. Most of the negative effects associated with IDA were
resolved by IPC treatment. Especially FS treatment was found to elicit hepatic damage in the dams, oxidative stress in the
dams, fetuses and placenta as well as inflammation and high levels of HIF-1α in the placenta. Pregnancy outcome of FFand
FS-treated animals was worse than that of IPC-treated animals.