CLINICAL QUESTION

How do the safety and effectiveness of intravenous (IV) iron compare with oral iron in the treatment of anemia in the prenatal and postpartum periods?

EVIDENCE-BASED ANSWER

In the prenatal setting, treatment of iron deficiency anemia with IV iron rather than oral iron may slightly increase the hemoglobin level 3 to 6 weeks after treatment and around the time of birth¹; however, there is no significant effect on postpartum hemorrhage, need for blood transfusion, or rates of breast-feeding.¹ (Strength of Recommendation [SOR]: C, consensus, disease-oriented evidence, usual practice, expert opinion, or case series for studies of diagnosis, treatment, prevention, or screening.)

In the postpartum setting among patients with iron deficiency anemia, IV iron therapy is associated with increased treatment adherence, a slight reduction in fatigue in the first month, and lower risk of constipation compared with oral iron treatment.² (SOR: A, inconsistent or limited-quality patient-oriented evidence.)