Effect of treatment with single total-dose intravenous iron versus daily oral iron(III)-hydroxide polymaltose on moderate puerperal iron-deficiency anemia

• Published in: Therapeutics and clinical risk management 2017-01, Vol.13, p.647-653
• Main Authors: Iyoke, Chukwuemeka Anthony, Emegoakor, Fausta Chioma, Ezugwu, Euzebus Chinonye, Lawani, Lucky Osaheni, Ajah, Leonard Ogbonna, Madu, Jude Anazoeze, Ezegwui, Hyginus Uzo, Ezugwu, Frank Okechukwu
• Format: Article
• Language: English
• Subjects: Analysis; Anemia; Blood; Breastfeeding & lactation; Care and treatment; Causes of; Childbirth & labor; Clinical trials; Developing countries; Diagnosis; Gynecology; Health aspects; Hemoglobin; intravenous; Iron; Iron deficiency anemia; iron-deficiency; LDCs; Obstetrics; Original Research; Postpartum period; Pregnancy; Prevalence studies (Epidemiology); Puerperal; Response rates; Sucrose; Teaching hospitals; Well being; Women; Womens health
• ISSN: 1176-6336; 1178-203X; 1178-203X
• DOI: 10.2147/TCRM.S112227

Iron-deficiency anemia is the most common nutritional cause of anemia in pregnancy and is often responsible for puerperal anemia. Puerperal anemia can impair postpartum maternal and neonatal well-being. To determine the effect of treatment of moderate puerperal iron-deficiency anemia using a single intravenous total-dose iron dextran versus daily single dose oral iron(III)-hydroxide polymaltose. A randomized controlled study in which postpartum women with moderate iron-deficiency anemia were randomized into treatment with either a single total-dose intravenous iron dextran or with daily single doses of oral iron(III)-hydroxide polymaltose tablets for 6 weeks. Effects on hemoglobin concentration using either method were compared at 6 weeks postpartum. Analysis was per protocol using SPSS version 17 for windows. -values ≤0.05 were considered significant. Two hundred eighty-four women were recruited for the study: 142 women received single total dose intravenous infusion of iron dextran while 142 received daily oral iron(III)-hydroxide polymaltose tablets. Approximately 84.0% (237/282) completed the study and were analyzed including 81% (115/142) of those randomized to injectable iron therapy compared to 85.9% (122/142) of those randomized to oral treatment. The proportions of women who had attained hemoglobin concentration of at least 10 g/dL by the 6 weeks postpartum visit did not differ significantly between cases and controls (95.7% vs 94.3%; =0.73). Similarly, the mean increases in hemoglobin following either therapeutic route were comparable (1.03±0.56 g/dL for intravenous iron and 0.97±0.46 g/dL for the oral group; =0.42). Single total-dose intravenous iron for treatment of puerperal iron-deficiency anemia was as effective as daily single doses of ferric iron tablets. For puerperal patients with iron-deficiency anemia in whom compliance with and tolerability of oral iron are not certain, a single total-dose intravenous iron can be safely offered.