Comparison Between the Effectiveness of Intravenous Infusion and Oral Iron Treatment of Postpartum Iron Deficiency Anemia

Abstract

Background: Postpartum iron deficiency anemia remains a significant public health concern globally, specifically concerning women in low-and middle-income countries. In South Asia, involving Bangladesh and India, the prevalence is frighteningly extreme due to factors such as poor nutritional status, frequent pregnancies, and inadequate access to quality postpartum care. Aim: To find out the association between the effectiveness of intravenous infusion and oral iron therapy in the treatment of postpartum iron deficiency anemia. Methods: A randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, BMU, Dhaka, from July 2023 to June 2024, among 92 postpartum women with iron deficiency anemia (Hb 7-9.9 g/dL, serum ferritin <30 µg/L). Participants were randomly allocated into two equal groups using a simple lottery method. Group I (n=46) received intravenous ferric carboxymaltose based on body weight and hemoglobin level, while Group II (n=46) received oral ferrous ascorbate (48 mg) twice daily for six weeks along with folic acid and zinc. Hemoglobin and serum ferritin levels were measured at baseline, two weeks, and six weeks to evaluate early and sustained hematologic response. Adverse events and compliances were also recorded. Data were analyzed using SPSS version 26, and a p-value of less than 0.05 was considered statistically significant. Results: A total of 92 postpartum women were add in, similarly allotted concerning intravenous (n=46) and oral (n=46) iron treatment groups. On 6 weeks, 43.5% of participants stayed anemic. In general, 65.2% of respondents stated that there is at least one side effect faced. Oral iron was more repeatedly associated with gastrointestinal symptoms like constipation and GI pain, while dysgeusia and headache were more prevalent with intravenous iron. Mostly side effects were mild to moderate. Together 2-week (p=0.044) and 6-week (p=0.003) hemoglobin recovery was significantly allied with treatment type. Intravenous iron confirmed excellent effectiveness in recovering hemoglobin quantities than oral iron (p=0.000). Conclusion: This study presents further verification that intravenous iron is more efficient than oral iron in developing hemoglobin levels among women with postpartum iron deficiency anemia. While oral iron remains a feasible selection, mainly in resource-limited settings, intravenous iron should be reflected for women who demand a prompt and effective improvement of anemia, specifically in cases with severe symptoms or intolerance to oral iron.