Comparison of intravenous ferrous sucrose and oral ferrous sulphate in treatment of postpartum iron deficiency anemia

Objective: The objective of the study was to evaluate the efficacy, safety and tolerability of intravenous ferrous sucrose, compared to oral ferrous sulphate in women with postpartum iron deficiency anemia (IDA).Methods: In a single center, randomized, controlled study, 352 patients with hemoglobin 9gm/dl or less and serum ferritin of <15g/l two days after delivery were equally randomized to receive intravenous ferrous sucrose (up to three calculated replacement doses) or oral ferrous sulphate (150mg twice daily for six weeks). Primary measures were to assess the rise in hemoglobin (Hb) and serum ferritin.Results: By day 5, the Hb level in women treated with intravenous ferrous sucrose had rised from 8.480.47 to 9.4 +/- 0.56gm/dl. Women treated with intravenous ferrous sucrose had significantly higher Hb levels on day 5, day 14 and day 40 (p<0.01) than those treated with oral ferrous sulphate. Throughout the study, ferritin level rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (p<0.001).Conclusion: Intravenous ferrous sucrose increases Hb level more rapidly than ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly with better tolerability.