Oral versus Parenteral Iron Supplements: Which is better in Postpartum Iron Deficiency Anemia?

Aims: To assess the safety and effectiveness of iron sucrose complex given intravenously versus ferrous sulphate taken orally in the treatment of iron deficiency anemia in the postpartum period.

Study Design: Randomized Clinical Trial.

Place and Duration of Study: Sahiwal Medical College, Sahiwal (Pakistan) from August to November, 2017.

Methodology: We included 386 patients with Iron Deficiency Anemia in postpartum period according to our criteria and distributed them among two groups. Group-A patients received intravenous Iron Sucrose complex while Group-B patients were treated with oral iron sulfate. Hemoglobin level, hematocrit, mean corpuscular volume and serum ferritin were used as indicators of anemia and results obtained for reversal of anemia and frequency of adverse effects were later analyzed.

Results: Varying degree of reversal of anemia was obtained in 386 patients included in the study. Patients treated with intravenous therapy had better reversal of anemia as compared to those who received oral iron sulfate with a P-Value of 0.03, 0.08, 0.049, and 0.01 for Hemoglobin, hematocrit, mean corpuscular volume, and serum ferritin, respectively with a margin of error of 5% and within the confidence interval of 95%. Comparison of adverse effects in both groups proved safer profile of intravenous therapy with a Pearson’s Chi-square value at 0.046.

Conclusion: Intravenous iron sucrose complex has higher clinical efficacy as compared to oral iron sulfate tablets in the treatment of iron deficiency anemia in postpartum women. Furthermore, intravenous iron therapy has a good safety profile with infrequent tolerable adverse effects.