Examining prescribing practices with respect to oral iron supplementation for post-partum anemia: a retrospective review

Abstract

Objectives Treatment for postpartum anemia frequently entails oral iron supplementation, but questions remain regarding its optimal dosing, frequency, and efficacy. The objective of this study was to describe oral iron prescribing practices in post-partum women and identify factors predictive of iron supplementation. Methods A retrospective chart review of women delivering at Sunnybrook Health Sciences Centre between May 2019 and April 2020 was undertaken. This group was chosen due to the routine availability of a post-operative complete blood count. Patient demographics, hematological indices, surgical indications and discharge prescriptions were collected. Post-partum anemia was defined as having a post-partum hemoglobin below 100 g/L. Univariate and multivariable analyses were performed in order to identify factors associated with treatment. Results Over the study period, 1580 patients delivered by Cesarean section; 1470 had a complete blood count collected on admission and were included in the study. The mean age at delivery was 34.4 years (SD 4.9) and mean gestational age was 37.2 weeks (SD 3.6). 92% of pregnancies were singleton. 14% of patients received a discharge prescription for oral iron (71% ferrous salt). In the multivariable analysis, factors significantly associated with treatment were earlier gestational age (OR 0.9), history pregnancy or labour-associated complications (OR 1.9), higher blood loss volume (OR 2.7), post-partum anemia (OR 5.7), red blood cell transfusion (OR 5.4) and antenatal iron supplementation (OR 5.7). Conclusions Several factors associated with post-partum iron supplementation were identified. This information will help inform future prospective studies investigating the efficacy of oral iron supplementation in the treatment of post-partum anemia.