Long-Term Efficacy of Postpartum Intravenous Iron Therapy

BACKGROUND The potential benefits of administering a dose of intravenous iron in patients with moderate postpartum anaemia rather than oral iron alone remains unproven. AIMS To determine whether a single injection of intravenous iron followed by a 6-week course of oral iron is as effective over 6 months in restoring normal haemoglobin levels and replenishing iron stores in women with moderate postpartum anaemia as a course of oral iron alone in women with mild postpartum anaemia. MATERIALS AND METHODS Retrospective two-arm cohort study in women with mild postpartum anaemia (haemoglobin 9.6-10.5 g/dL) prescribed iron daily for 6 weeks (N=150) and women with moderate postpartum anaemia (haemoglobin 8.5-9.5 g/dL), given a single 500 mg injection of intravenous iron followed by iron daily for 6 weeks (N=75). Haemoglobin and ferritin were measured 6 months postpartum. RESULTS Haemoglobin returned to similar mean levels in both groups. Ferritin levels were statistically significantly higher in the intravenous+oral group (57.7±49.3 μg/L versus 32.9±20.1 μg/L). CONCLUSIONS Despite lower baseline haemoglobin, intravenous iron carboxymaltose was superior to oral iron alone in replenishing iron stores in moderate postpartum anaemia and may prove similarly beneficial in mild postpartum anaemia.