Prevalence and Management of Postpartum Anaemia in a Tertiary Care Hospital in North India

ABSTRACT

Postpartum iron deficiency anaemia (IDA) is common in women in resource-poor countries. Most women are treated with either oral iron or blood transfusion. The aim of our study was to find out the prevalence of postpartum anemia; and to compare the effect of treatment with either oral ferrous sulphate or intravenous iron sucrose on postpartum IDA. Methods: 102 postpartum women with proven iron deficiency anemia with hemoglobin <9gm/dl and serum ferritin <15 µgm/l were included in the study. They were randomized to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group 1) or intravenous ferrous sucrose 200 mg , two to three doses given on alternate days (group 2). Total iron deficit was calculated using standard formula and results analyzed. Main outcome measures: Hemoglobin, hematocrit, red cell indices and ferritin were measured on day 2-3, 1-2 weeks and 6 weeks postpartum. Result: The prevalence of postpartum anaemia was 19.92%. By 1-2 weeks, hemoglobin level in women treated with intravenous iron had risen from 7.81± 0.849 to 9.88± 0.760 gm/dl which was more than those treated with oral iron (p<0.0001); although by 6 weeks, there was no significant difference between the two groups. Ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (p<0.0001). Conclusion: Intravenous iron sucrose increases the hemoglobin level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly.