A comparative study of intravenous iron sucrose versus oral iron therapy in iron deficiency anemia during postpartum period


  • Santosh Khajotia Department of Obstetrics and Gynecology, S. P. Medical College, Bikaner, Rajasthan University of Health Sciences, Rajasthan, India
  • Shubha Meena Department of Obstetrics and Gynecology, S. P. Medical College, Bikaner, Rajasthan University of Health Sciences, Rajasthan, India
  • Deepak Naraniya Department of Obstetrics and Gynecology, S. P. Medical College, Bikaner, Rajasthan University of Health Sciences, Rajasthan, India




Iron deficiency anemia, Intravenous iron sucrose, Maternal mortality, Serum ferritin


Background: Anemia is the commonest major contributing factor in maternal mortality and morbidity in developing countries and according to World Health Organization (WHO) criteria, it contributes to 20% of maternal deaths. Anemia in pregnancy defined as haemoglobin level <11 gm/dl (7.45 mmol/L) and haematocrit less than 33% (WHO). Aim of this study was to compare the efficacy of oral iron ferrous sulphate therapy with intravenous iron sucrose therapy in the treatment of iron deficiency anemia during postpartum period.

Methods: This was a prospective randomized comparative clinical trial single center study conducted on 200 postpartum women aged >18 years (after normal delivery or LSCS) within 10 days of delivery with Hb level more or equal to 6 gm/dl but less than 10 gm/dl were included in the study. This was a one-year study conducted during 1st December 2018 to 30th November 2019.

Results: There was a significant increase in the hemoglobin level in both the groups i.e. in IV iron group, from 8.26±1.03 gm/dl on day 1 to 11.62±0.94 gm/dl on day 45 as compared to oral iron group, from 8.24±1.09 gm/dl on day 1 to 11.07±1.14 gm/dl on day 45; and serum ferritin level from 41.69±40.45 ng/ml on day 1 to 77.34±41.60 ng/ml on day 45 in IV iron group as compared to the oral iron group from 22.20±8.82 ng/ml on day 1 to 31.72±9.72 ng/ml on day 45. So, there was a rapid increase in both hemoglobin and serum ferritin levels in IV iron group as compared to the oral iron group.

Conclusions: Intravenous iron sucrose administration increases the hemoglobin level and serum ferritin more rapidly in compare to the oral intake of ferrous sulphate in women with iron deficiency anemia in postpartum women in our study.



Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstap LC, Wenstrom KD, et al. Hematological Disorders. Cox SM, Werner CL, Hoffman BL, Cunningham FG eds. In: William’s Obstetrics, 22nd ed. New York, NY: McGraw Hill; 2005:1144-1145.

de Benoist D, McLean E, Egli I, Cogswell M. Worldwide prevalence of anaemia 1993-2005. WHO global database on anaemia; 2008.

World Health Organization. Maternal Health and safe motherhood programme and WHO. Nutrition programme. The prevalence of anaemia in women: a tabulation of available information, 2nd ed WHO. 1992. Available at: https://apps.who.int/iris/handle/1665/58994. Accessed on 10th February 2020.

ACC/SCN (United Nations Administrative Committee on Coordination/Standing Committee on Nutrition). Fifth report on the world nutrition situation: Nutrition for improved development outcomes. Geneva, Switzerland, accscn@who.org; 2004.

Arias F. In: Practical guide to high risk pregnancy and delivery, 2nd edition; 2005;16(4):245-57.

Dutta DC. Medical illness complicating pregnancy. In: Textbook of Obstetrics, 6th edition. (Ed Konar H) The central Book Agency Pvt Ltd. Culcutta; 2004:262-71.

Cunninghum FG, Lenevo KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Haematological disorder. Editor. In: Williams obstetrics, 23rd edition. Philadelphia, McGraw Hill; 2010;1080.

Bhandal N, Russell R. intravenous versus oral iron therapy for postpartum anemia. BJOG. 2006;113(11):1248-52.

Kotto-Kome AC, Calhoun DA, Montenegro R, Sosa R, Maldonado L, Christensen MD. Effect of administering recombinant erythropoietin to women with postpartum anemia: a meta-analysis. J Perinatol. 2004;24:11-5.

Hypochromic anemias: Iron deficiency and Sideroblastic. In: DeGruchy’s clinical hematology in clinical practice. Firkin F, Perington D, Rush B, Chesterman C. (eds). Blackwell Science Publication. Fifth edition; 1989:31-60.

Giannoulis C, Daniilidis A. Intravenous administration of iron sucrose for treating anemia in postpartum women. Hippokratia. 2009;13(1):38-40.

Breymann C. Treatment of iron deficiency anaemia in pregnancy and postpartum with special focus on intravenous iron sucrose complex. J Med Asso Thai. 2005;88:S108-9.

Atkinson LA, Baxley EG. Postpartum fatigue. Am Fam Physician. 1994;50:113-8.

Policy on control of nutritional anemia. Ministry of health and Family Walfare, Government of India, 1991. Available at: http;//hetv.org/pdf/anaemiapolicy.pdf. Accessed on 12th February 2020.

Kharde PS, Bangal VB. dept. of obs. and gyne, rural medical college and pravara rural hospital and institute of medical sciences (Deemed University) Loni Ahmednagar, Maharashtra, India. IJBAR. 2012;03(04):238-43.

Pradhan S, Patel O, Raju MD, Dash P. Study of oral versus intravenous iron therapy in postpartum anaemic women. J Evolution Med Dent Sci. 2017;6(54):4101-6.






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