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Background & Aims: Prescribing routine Iron supplementation during pregnancy regardless of the maternal hemodynamic condition that may be accompanied with pregnancy and delivery complications. This study conducted to assessing the effect of iron supplementation in pregnant women with high hemoglobin on delivery type and newborn’s Apgar score. Material & Methods: The randomized double-blind clinical trial performed on 140 healthy pregnant women, 18-35years old, normal BMI, nonsmoker, in the 14th - 18th weeks of singleton pregnancy with Hb> 13.2 g/dL and ferritin > 15 μg/l. Mothers were randomly assigned to experimental and control groups from the 20th week of pregnancy, the experimental group received one ferrous sulfate tablet (50 mg) daily, while the control group received a placebo. Both of them were followed up to delivery and the type of birth and newborn’s Apgar were evaluated and compared. Results: There was significant differences between the two groups in Hb (P = 0.03) and ferritin (P=0.04) levels after intervention, but the incidence of anemia exhibited no difference between them (P = 0.1). In addition there was no different between the two groups in birth weight (P=0/2), but the incidence of cesarean section (P=0/01) and low birth Apgar score (less than 8) (P=0/02) in drug group more than other group. Conclusion: Iron supplementation increased the risk of cesarean section and low Apgar score in pregnant women with Hb concentrations greater than 13.2 g/dl therefore, it should be done with caution in pregnancy.

Keywords: Ferrous sulfate, Pregnancy, Hemoglobin, Apgar score, cesarean

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