Intravenous versus oral iron therapy for postpartum anaemia
Article first published online: 27 SEP 2006
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 113, Issue 11, pages 1248–1252, November 2006
How to Cite
Bhandal, N. and Russell, R. (2006), Intravenous versus oral iron therapy for postpartum anaemia. BJOG: An International Journal of Obstetrics & Gynaecology, 113: 1248–1252. doi: 10.1111/j.1471-0528.2006.01062.x
- Issue published online: 27 SEP 2006
- Article first published online: 27 SEP 2006
- Accepted 25 July 2006. Published OnlineEarly 28 September 2006.
- Intravenous iron sucrose;
- oral ferrous sulphate;
- postpartum anaemia
Objective Postpartum iron deficiency anaemia (IDA) is common in women. Most women are treated with either oral iron supplementation or blood transfusion. Hence, the aim of our study was to compare the effect of treatment with either oral ferrous sulphate or intravenous ferrous sucrose on postpartum IDA.
Design A single centre, prospective randomised controlled trial.
Setting Women’s Centre, John Radcliffe Hospital, Oxford, UK.
Population Forty-four women with haemoglobin (Hb) of <9 g/dl and ferritin of <15 microgram/l at 24–48 hours postdelivery.
Methods Women were randomised to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group O) or intravenous ferrous sucrose 200 mg (Venofer; Vifor International Ltd, St Gallen, Switzerland), two doses given on days 2 and 4 following recruitment (group I). Results were analysed by the Students t-test, chi-square test and analysis of variance.
Main outcome measures Hb, haematocrit, red cell indices, ferritin and serum iron levels were measured on days 0, 5, 14 and 40.
Results By day 5, the Hb level in women treated with intravenous iron had risen from 7.3 ± 0.9 to 9.9 ± 0.7 g/dl, while there was no change in those treated with oral iron. Women treated with intravenous iron had significantly higher Hb levels on days 5 and 14 (P < 0.01) than those treated with oral iron; although by day 40, there was no significant difference between the two groups. Throughout the study, ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (P < 0.01).
Conclusions Intravenous iron sucrose increases the Hb level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also appears to replenish iron stores more rapidly. However, this study was not large enough to address the safety of this strategy.