Long-term efficacy of postpartum intravenous iron therapy

The potential benefits of administering a dose of intravenous iron in patients with moderate postpartum anaemia rather than oral iron alone remains unproven.

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.

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.

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).

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.