Oral Versus Intravenous Iron Therapy for Postpartum Anemia: A Systematic Review and Meta-analysis

Abstract

(Am J Obstet Gynecol. 2019;19.e2–29.e2) Postpartum anemia is associated with fatigue, depression, and impaired cognition. Postpartum anemia affects up to 50% of women in well-resourced countries and up to 80% of women in developing countries, which can affect maternal-child bonding. However, adverse gastrointestinal reactions to oral iron treatments (ie, nausea, vomiting, and constipation) occur in up to 40% of patients, resulting in poor compliance and persistent anemia. Intravenous (IV) iron may be ideal for these patients, as it mitigates the absorption challenges and produces a more rapid increase in hemoglobin (Hb) concentration and iron stores. The disadvantages of IV iron include increased cost and the need for treatment at a hospital or outpatient facility. This study was an updated systematic review of all randomized trials comparing oral versus IV iron therapy to treat postpartum anemia. The primary outcome measure was postpartum Hb.