Maternal iron deficiency anemia increases the risk of peripartum blood transfusion, fatigue, and adverse neonatal outcomes, while oral iron is frequently limited by poor absorption and gastrointestinal intolerance. In this randomized controlled clinical trial, pregnant individuals with confirmed iron deficiency anemia were allocated to either intravenous ferumoxytol or daily oral ferrous sulfate through delivery. Intravenous ferumoxytol achieved significantly higher maternal hemoglobin concentrations at delivery and led to a marked reduction in the overall prevalence of maternal anemia at term compared with oral therapy.

Treatment-related adverse events were infrequent, and compliance was superior in the intravenous infusion group. These findings demonstrate that intravenous ferumoxytol provides more rapid and reliable correction of gestational iron deficiency anemia than standard oral…