Fatigue was reported in two studies and improved significantly favouring the intravenously treated group in one of the studies. Intravenous iron was compared to oral iron in 10 studies (1553 women). No analysis of our primary outcomes contained more than two studies. Many comparisons are based on a small number of studies with small sample sizes. We included 22 randomised controlled trials (2858 women), most of which had high risk of bias in several domains. presence and severity of anaemia symptoms balanced against harms, i.e. We could not draw conclusions regarding erythropoietin treatment due to lack of evidence.įurther research should evaluate treatment effect through clinical outcomes, i.e. When comparing oral iron to placebo it remains unknown whether efficacy (relief of anaemia symptoms) outweighs the documented gastrointestinal harms. maternal mortality (not reported) and maternal immunological sensitisation, which can potentially harm future pregnancies. The clinical significance of some temporarily improved fatigue scores in women treated with blood transfusion is uncertain and this modest effect should be balanced against known risks, e.g. Intravenous iron was superior regarding gastrointestinal harms, however anaphylaxis and cardiac events occurred and more data are needed to establish whether this was caused by intravenous iron. It remains unclear which treatment modality is most effective in alleviating symptoms of postpartum anaemia. Laboratory values may not be reliable indicators for efficacy, as they do not always correlate with clinical treatment effects. The quality of evidence was low.Ĭlinical outcomes were rarely reported. The body of evidence did not allow us to reach a clear conclusion regarding the efficacy of the interventions on postpartum iron deficiency anaemia. The body of evidence did not allow us to fully evaluate the efficacy of the treatments on iron deficiency anaemia after childbirth and further research is needed. Very few studies reported on relief of anaemia symptoms, although this is perhaps the most important purpose of treatment. Other treatment options were compared in other studies, which did not investigate fatigue. It remains unknown whether benefits of oral iron outweigh documented gastrointestinal harms. When comparing oral iron to placebo (three studies), anaemia symptoms were not reported. Some (but not all) fatigue scores temporarily improved in the transfused women. One study compared red blood cell transfusion with no transfusion. Gastrointestinal symptoms were frequent in the oral group and caused some participants to abandon treatment. Allergic reactions occurred in three women, and heart complications in two women in the intravenous group. Only two studies reported on maternal deaths. One woman died from heart complications in the intravenous group. Other anaemia symptoms were not reported.
Only one study showed a temporary positive effect on fatigue for intravenous iron. Ten studies, including 1553 women, compared intravenous iron with oral iron. Most trials were conducted in high-income countries. We included 22 randomised controlled studies with 2858 women and performed 13 comparisons, many of which were based on few studies involving small numbers of women. It is important to investigate if one treatment is better than another in relieving anaemia symptoms, and whether the treatment options are safe. Another option is to restore red blood cells through transfusion with blood from a blood donor or to boost red blood cell formation with erythropoietin. Treatment for iron deficiency anaemia includes iron tablets or a solution injected into a vein (intravenously). Iron deficiency anaemia after childbirth is more likely to occur in low-income countries. Severe anaemia can be linked to maternal deaths. Women may bleed severely at childbirth and many pregnant women already have anaemia, which can worsen as a result of bleeding. Anaemia symptoms include tiredness, shortness of breath and dizziness.
Insufficient iron intake/uptake and iron loss (bleeding) can cause iron deficiency anaemia. Haemoglobin is the molecule within red blood cells that requires iron to carry oxygen. Anaemia is a condition where the blood contains less than normal haemoglobin (low blood count), as shown in blood tests.
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