Cochrane · systematic review · CD010861
Treatment for women with postpartum iron deficiency anaemia
Markova, V, Norgaard, A, Jørgensen, KJ, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
17
No studies
23
Included studies
NR
No studies 23 · 54.8%Ungraded 2 · 4.8%Very low 11 · 26.2%Low 5 · 11.9%Moderate 1 · 2.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Intravenous iron compared with oral iron for women with postpartum iron deficiency anaemia (Comparison 1)
Population: women with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality Clinical assessment Intravenous iron vs oral iron | RR 2.95 [0.12, 71.96] | 2 studies · 374 participants | Low Downgraded: risk of bias, imprecision |
Fatigue at 14, 28, and 42 days Fatigue Linear Analog Scale Assessment. Scale from: 0 to 100. Intravenous iron vs oral iron | no estimate extracted | 1 study · 361 participants | Very low Downgraded: risk of bias, imprecision |
Persistent anaemia symptoms ‐ not reported Intravenous iron vs oral iron | no estimate extracted | NR | No studies |
Infections Clinical assessment Intravenous iron vs oral iron | RR 1.7 [0.58, 5.03] | 3 studies · 718 participants | Very low Downgraded: risk of bias, inconsistency |
Constipation Reported by the women Intravenous iron vs oral iron | RR 0.21 [0.11, 0.39] | 6 studies · 1217 participants | Very low Downgraded: risk of bias |
All gastrointestinal symptoms Reported by the women Intravenous iron vs oral iron | RR 0.31 [0.2, 0.47] | 8 studies · 1307 participants | Very low Downgraded: risk of bias |
Anaphylaxis or evidence of hypersensitivity Clinical assessment Intravenous iron vs oral iron | RR 2.78 [0.31, 24.92] | 8 studies · 1454 participants | Low Downgraded: risk of bias, imprecision |
Red blood cell transfusion compared with non‐transfusion (Comparison 2)
Population: patients with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality ‐ not reported Red blood cell transfusion vs non‐transfusion (Comparison 2) | no estimate extracted | NR | No studies |
Fatigue Multidimensional Fatigue Inventory. Scale from: 4 to 20. Red blood cell transfusion vs non‐transfusion (Comparison 2) | no estimate extracted | 1 study · 519 participants | Low Downgraded: risk of bias |
Persistent anaemia symptoms Reported by the women Red blood cell transfusion vs non‐transfusion (Comparison 2) | no estimate extracted | 1 study · 519 participants | Very low Downgraded: risk of bias |
Infections Clinical assessment Red blood cell transfusion vs non‐transfusion (Comparison 2) | RR 0.93 [0.53, 1.61] | 1 study · 519 participants | Moderate Downgraded: risk of bias |
Erythrocyte alloantibody formation Laboratory assessment Red blood cell transfusion vs non‐transfusion (Comparison 2) | RR 3.03 [0.12, 74.15] | 1 study · 519 participants | Very low Downgraded: risk of bias, imprecision |
Thromboembolic events Assessment method not described Red blood cell transfusion vs non‐transfusion (Comparison 2) | RR 1.01 [0.14, 7.13] | 1 study · 519 participants | Low Downgraded: risk of bias, imprecision |
Transfusion reactions Clinical assessment Red blood cell transfusion vs non‐transfusion (Comparison 2) | RR 7.08 [0.37, 136.41] | 1 study · 519 participants | Very low Downgraded: risk of bias, imprecision |
Oral iron compared with placebo (Comparison 3)
Population: women with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality ‐ not reported Oral iron vs placebo (Comparison 3) | no estimate extracted | NR | No studies |
Fatigue ‐ not reported Oral iron vs placebo (Comparison 3) | no estimate extracted | NR | No studies |
Persistent anaemia symptoms Reported by the women Oral iron vs placebo (Comparison 3) | no estimate extracted | 1 study · 1 participants | Ungraded |
All gastrointestinal symptoms Reported by the patients Oral iron vs placebo (Comparison 3) | RR 1 [0.36, 2.79] | 1 study · 68 participants | Very low Downgraded: risk of bias, imprecision |
Constipation ‐ not reported Oral iron vs placebo (Comparison 3) | no estimate extracted | NR | No studies |
Intravenous iron with oral iron compared with oral iron (Comparison 6)
Population: women with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality Intravenous iron with oral iron vs oral iron (Comparison 6) | no estimate extracted | NR | No studies |
Fatigue ‐ not reported Intravenous iron with oral iron vs oral iron (Comparison 6) | no estimate extracted | NR | No studies |
Persistent anaemia symptoms ‐ 1 week Visual Analogue Scale ≥ 7 Intravenous iron with oral iron vs oral iron (Comparison 6) | RR 1.75 [0.56, 5.46] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Persistent anaemia symptoms ‐ 2 weeks Visual Analogue Scale ≥ 7 Intravenous iron with oral iron vs oral iron (Comparison 6) | RR 0.6 [0.15, 2.33] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Persistent anaemia symptoms ‐ 6 weeks Visual Analogue Scale ≥ 7 Intravenous iron with oral iron vs oral iron (Comparison 6) | RR 3 [0.33, 27.5] | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Infections ‐ not reported Intravenous iron with oral iron vs oral iron (Comparison 6) | no estimate extracted | NR | No studies |
Anaphylaxis or evidence of hypersensitivity Clinical assessment Intravenous iron with oral iron vs oral iron (Comparison 6) | no estimate extracted | 0 studies · 1 participants | Low Downgraded: risk of bias |
Erythropoietin (regardless of rout) with intravenous iron compared with intravenous iron (Comparison 7)
Population: women with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality Erythropoietin (regardless of rout) with intravenous iron vs intravenous iron (Comparison 7) | no estimate extracted | NR | No studies |
Fatigue ‐ not reported Erythropoietin (regardless of rout) with intravenous iron vs intravenous iron (Comparison 7) | no estimate extracted | NR | No studies |
Thromboembolic events ‐ not reported Erythropoietin (regardless of rout) with intravenous iron vs intravenous iron (Comparison 7) | no estimate extracted | NR | No studies |
Persistent anaemia symptoms ‐ not reported Erythropoietin (regardless of rout) with intravenous iron vs intravenous iron (Comparison 7) | no estimate extracted | NR | No studies |
Subcutaneous EPO 10,000 U of doses with intravenous iron compared with intravenous iron (Comparison 8)
Population: patients with women with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality ‐ not reported Subcutaneous EPO 10,000 U of doses with intravenous iron vs intravenous iron (Comparison 8) | no estimate extracted | NR | No studies |
Fatigue ‐ not reported Subcutaneous EPO 10,000 U of doses with intravenous iron vs intravenous iron (Comparison 8) | no estimate extracted | NR | No studies |
Persistent anaemia symptoms ‐ not reported Subcutaneous EPO 10,000 U of doses with intravenous iron vs intravenous iron (Comparison 8) | no estimate extracted | NR | No studies |
Thromboembolic events ‐ not reported Subcutaneous EPO 10,000 U of doses with intravenous iron vs intravenous iron (Comparison 8) | no estimate extracted | NR | No studies |
Subcutaneous EPO with oral iron compared with oral iron (Comparison 10)
Population: women with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality Subcutaneous EPO with oral iron vs oral iron (Comparison 10) | no estimate extracted | 0 studies · 40 participants | Ungraded |
Fatigue ‐ not reported Subcutaneous EPO with oral iron vs oral iron (Comparison 10) | no estimate extracted | NR | No studies |
Persistent anaemia symptoms ‐ not reported Subcutaneous EPO with oral iron vs oral iron (Comparison 10) | no estimate extracted | NR | No studies |
Thromboembolic events ‐ not reported Subcutaneous EPO with oral iron vs oral iron (Comparison 10) | no estimate extracted | NR | No studies |
Subcutaneous EPO with intravenous iron and oral iron compared with intravenous iron with oral iron (Comparison 12)
Population: women with postpartum iron deficiency anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal mortality ‐ not reported Subcutaneous EPO with intravenous iron and oral iron vs intravenous iron with oral iron (Comparison 12) | no estimate extracted | NR | No studies |
Fatigue ‐ not reported Subcutaneous EPO with intravenous iron and oral iron vs intravenous iron with oral iron (Comparison 12) | no estimate extracted | NR | No studies |
Persistent anaemia symptoms ‐ not reported Subcutaneous EPO with intravenous iron and oral iron vs intravenous iron with oral iron (Comparison 12) | no estimate extracted | NR | No studies |
Thromboembolic events ‐ not reported Subcutaneous EPO with intravenous iron and oral iron vs intravenous iron with oral iron (Comparison 12) | no estimate extracted | NR | No studies |