• Stian Westad, Bjørn Backe, Kjell Asmund Salvesen, Jakob Nakling, Inger Økland, Ingrid Borthen, Odd Harald Rognerud Jensen, Toril Kolås, Bjarne Løkvik, and Eli Smedvig.
• Department of Obstetrics and Gynecology, Innlandet Hospital Trust, Lillehammer, Norway. stian.westad@sykehuset-innlandet.no
• Acta Obstet Gynecol Scand. 2008 Jan 1; 87 (9): 916-23.

ObjectiveTo analyze the effect of intravenous ferrous sucrose compared with oral ferrous sulphate on hematological parameters and quality of life in women with postpartum anemia.DesignOpen randomised controlled trial.SettingMulticentre study comprising five obstetrical departments in Norway.PopulationHundred and twenty-eight postpartum women with hemorrhagic anemia (Hb between 6.5 g/100 ml and 8.5 g/100 ml). The intervention group (59 women) received 600 mg iron sucrose intravenously followed by 200 mg iron sulphate daily from week 5. The control group (70 women) were given 200 mg iron sulphate daily.MethodsRandomisation and start of treatment occurred within 48 hours of the delivery. Participants were followed up at 4, 8 and 12 weeks.Main Outcome MeasuresHemoglobin, ferritin and quality of life assessed with the Medical Outcomes Study Short Form 36 (SF-36) and the Fatigue Scale.ResultsAfter 4 weeks the mean hemoglobin values in both groups were similar (11.9 g/100ml vs. 12.3g/100ml, p=0.89). The mean serum ferritin value after 4 weeks was significantly higher in the intervention group with 13.7 microg/L vs. 4.2 microg/L in the control group (p<0.001). At 8 and 12 weeks the hematological parameters were similar. The total fatigue score was significantly improved in the intervention group at week 4, 8 and 12, whereas SF-36 scores did not differ.ConclusionWomen who received 600 mg intravenous iron sucrose followed by standard oral iron after four weeks, replenished their iron stores more rapidly and had a more favorable development of the fatigue score indicating improved quality of life.

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