Summary of findings 4. Intravenous iron with oral iron compared with oral iron (Comparison 6).
| Intravenous iron with oral iron compared with oral iron for women with postpartum iron deficiency anaemia | ||||||
| Patient or population: women with postpartum iron deficiency anaemia Settings: obstetric care unit Intervention: intravenous iron with oral iron Comparison: oral iron | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Oral iron | Intravenous iron with oral iron | |||||
| Maternal mortality | See comment | See comment | Not estimable | ‐ | See comment | In 1 study no maternal deaths were reported. The other study did not report on maternal mortality. |
| Fatigue ‐ not reported | See comment | See comment | Not estimable | ‐ | See comment | Not reported. |
| Persistent anaemia symptoms ‐ 1 week Visual Analogue Scale ≥ 7 Follow‐up: mean 7 days | Study population | RR 1.75 (0.56 to 5.46) | 72 (1 study) | ⊕⊝⊝⊝ very low1,2 | ||
| 111 per 1000 | 194 per 1000 (62 to 607) | |||||
| Moderate | ||||||
| 111 per 1000 | 194 per 1000 (62 to 606) | |||||
| Persistent anaemia symptoms ‐ 2 weeks Visual Analogue Scale ≥ 7 Follow‐up: mean 14 days | Study population | RR 0.6 (0.15 to 2.33) | 72 (1 study) | ⊕⊝⊝⊝ very low1,2 | ||
| 139 per 1000 | 83 per 1000 (21 to 324) | |||||
| Moderate | ||||||
| 139 per 1000 | 83 per 1000 (21 to 324) | |||||
| Persistent anaemia symptoms ‐ 6 weeks Visual Analogue Scale ≥ 7 Follow‐up: mean 42 days | Study population | RR 3 (0.33 to 27.5) | 72 (1 study) | ⊕⊝⊝⊝ very low1,2 | ||
| 28 per 1000 | 83 per 1000 (9 to 764) | |||||
| Moderate | ||||||
| 28 per 1000 | 84 per 1000 (9 to 770) | |||||
| Infections ‐ not reported | See comment | See comment | Not estimable | ‐ | See comment | Not reported. |
| Anaphylaxis or evidence of hypersensitivity Clinical assessment Follow‐up: mean 28 days | Study population | Not estimable | 0 (1 study) | ⊕⊕⊝⊝ low1 | 1 study reported 0 events, other study pooled adverse events, not reporting allergic reactions separately. Thus the effect was not estimable. | |
| See comment | See comment | |||||
| Moderate | ||||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Downgraded two levels due to risk of bias: the included study had high risk of attrition and reporting bias. 2 Downgraded one level due to imprecision: small sample size, single study.