A 12‐week randomised study comparing intravenous iron sucrose versus oral ferrous sulphate for treatment of postpartum anemia

Westad, Stian; Backe, Bjørn; Salvesen, Kjell Å.; Nakling, Jakob; Økland, Inger; Borthen, Ingrid; Jensen, Odd Harald Rognerud; Kolås, Toril; Løkvik, Bjarne; Smedvig, E.

doi:10.1080/00016340802317802

Cited by 65 publications

(100 citation statements)

References 30 publications

(36 reference statements)

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“…This observation is highly significant in other studies thus indicating its use in postpartum anaemia. 2,[4][5][6][7][8][9] In present study, 40% of patients with oral iron had gastrointestinal side effects, which were comparable with various studies having 30% to 33% of their patients having these side effects. 2,4 Usually, GI complaints afflict up to 20% of patients taking ferrous iron salts.…”

Section: Discussionsupporting

confidence: 75%

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Intravenous versus oral iron therapy in treatment of postpartum anaemia

Agarwal

Sharma

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPostpartum anaemia is a common problem throughout the world and for most women is self limiting, resolving within a week. For some women however, particularly in resource-poor countries, it is a major cause of maternal morbidity and mortality.1 Postpartum haemoglobin (Hb) levels of <10 g/dl are observed in up to 30% of women, with more severe anaemia (Hb < 8g/dl) seen in 10%. Iron deficiency is the principal cause. This is partly attributable to an iron deficit during pregnancy, caused by the increased iron demands of the fetoplacental unit and an increased maternal red cell mass. 2Irrespective of mode of delivery, blood loss is a contributing factor, with 5% of deliveries involving loss of more than 1L. It appears to be higher in unfavorable socioeconomic conditions. The symptoms of postpartum anaemia vary and may include breathlessness, fatigue, palpitations, dizziness, maternal infections particularly of the urinary tract, lactation failure and prolonged hospital stay depending on the severity of blood loss and related anaemia. It has also been shown to be strongly associated with depression, stress and cognitive function in the postpartum period and may result in difficulty for the ABSTRACT Background: 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. Methods: 100 postpartum women with proven iron deficiency anaemia with hemoglobin <9gm/dl and serum ferritin <15 µgm/l were included in the study. They were randomized to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group 1) or intravenous ferrous sucrose 200 mg, two to three doses given on alternate days (group 2). Total iron deficit was calculated using a standard formula. Target hemoglobin was 11 gm/dl. Results were analysed by the students t-test and chi-square test. Hemoglobin, hematocrit, red cell indices and ferritin were measured on day 2-3, 1-2 weeks and 6 weeks postpartum Results: By 1-2 weeks, hemoglobin level in women treated with intravenous iron had risen from 7.81±0.849 to 9.88±0.760 gm/dl which was more than those treated with oral iron (p<0.01); although by 6 weeks, there was no significant difference between the two groups. 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 hemoglobin level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly.

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Section: Discussionsupporting

confidence: 75%

“…This indicates the response of iron therapy to be good in both the groups if compliance is assured. 2,[4][5][6][7][8][9] Serum ferritin is an indicator of iron stores, and decrease in its values indicates depletion of iron stores. In the present study, there was increase in serum ferritin in both the groups but more in I.V.…”

Section: Discussionmentioning

confidence: 99%

Intravenous versus oral iron therapy in treatment of postpartum anaemia

Agarwal

Sharma

2017

Int J Reprod Contracept Obstet Gynecol

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“…But the rise in Hb in oral group in above was less as compared to present study. In a 12-week randomised study comparing intravenous iron sucrose versus oral ferrous sulphate for treatment of postpartum anemia by Westad et al 12 , after 4 weeks the mean hemoglobin values in both groups were similar (11.9 g/100ml vs. 12.3g/100ml, p=0.89). The mean serum ferritin value after 4 weeks was significantly higher in the intervention group with 13.7 microgams/L vs. 4.2 micrograms/L in the control group (p<0.001).…”

Section: Methodsmentioning

confidence: 94%

Comparative Study of Intravenous Iron Sucrose Versus Oral Iron Therapy in Iron Deficiency Anemia During Postpartum Period

Kharde

Bangal

Panicker

2012

Int J of Biomed & Adv Res

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Background:-Nutritional anemia is one of major contributory factor in high maternal mortality and morbidity in third world countries. Iron deficiency is the principle cause for nutritional anemia. The aim of the study was to compare the efficacy of oral iron therapy with intravenous iron therapy in the treatment of iron deficiency anemia during postpartum period Material and Methods:-A clinical observational study was undertaken at tertiary care teaching hospital over a period of 15 months in one hundred recently delivered women. The baseline hemoglobin and serum ferritin levels were recorded prior to treatment. After completion of the treatment the women were followed up for changes in hemoglobin and serum ferritin levels on day 5, 14 and 40. Results :-.On day 5 of the intravenous iron group , there was statistically significant increase in serum ferritin level from 11.47 +1.655 µg/l to 41.44 +6.500 µg/l (p value <0.01), and the ferritin level remained elevated on day 14 and day 40. There was significant increase in mean Hb level from 7.76+0.7137 g/dl to 10.78+0.7679 g/dl on day 40 (p value < 0.01) in oral iron group. There was increase in mean Hb level from 7.47+0.7678 g/dl to 11.41+0.7908 g/dl on day 40 in injectable iron group, which was statistically significant. (p value < 0.01) Intravenous iron sucrose did not result in any serious adverse reactions. Conclusion:-Intravenous iron sucrose administration increases the hemoglobin level and serum ferritin levels more rapidly ,without any serious adverse effect in comparison with oral ferrous sulphate in women with iron deficiency anemia in the postnatal period .

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“…7 A total of 128 post-partum women with hemorrhagic anemia (Hb between 6.5 g/100 ml and 8.5 g/100 ml) were included in this study. After 4 weeks, the mean Hb values in both groups were similar (11.9 g/100 ml versus 12.3 g/100 ml, p = 0.89).…”

Section: Discussionmentioning

confidence: 99%

Comparison between intravenous iron sucrose versus oral iron therapy in pregnant women with nutritional anemia: a prospective study

Tandon¹,

Gupta²,

Chaudhari³

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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A 12‐week randomised study comparing intravenous iron sucrose versus oral ferrous sulphate for treatment of postpartum anemia

Abstract: Women who received 600 mg intravenous iron sucrose followed by standard oral iron after four weeks, replenished their iron stores more rapidly and had a more favorable development of the fatigue score indicating improved quality of life.

Cited by 65 publications

References 30 publications

Intravenous versus oral iron therapy in treatment of postpartum anaemia

Intravenous versus oral iron therapy in treatment of postpartum anaemia

Comparative Study of Intravenous Iron Sucrose Versus Oral Iron Therapy in Iron Deficiency Anemia During Postpartum Period

Comparison between intravenous iron sucrose versus oral iron therapy in pregnant women with nutritional anemia: a prospective study

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