Real-World Comparative Effectiveness of Ferric Derisomaltose Versus Conventional Iron Treatment in Postpartum Hemorrhage-Related Anemia.

BACKGROUND

Postpartum hemorrhage (PPH) can lead to acute iron deficiency anemia, negatively affecting maternal health and infant care by contributing to fatigue, depression, and difficulties with breastfeeding. There is a clinical need for rapid and effective iron supplementation.

OBJECTIVE

This study aimed to evaluate the real-world effectiveness of ferric derisomaltose (FDI), which allows for single high-dose intravenous administration, in comparison with conventional treatment combining intravenous and oral iron administration.

METHODS

This retrospective observational study included postpartum women with hemoglobin (Hb) levels <8 g/dL within three days after delivery between April 2023 and April 2025. Patients in the FDI group received a single 1000 mg intravenous dose of FDI, while the conventional treatment group received intravenous saccharated ferric oxide and oral sodium ferrous citrate. Hematologic parameters (Hb, serum iron, total iron-binding capacity, ferritin, reticulocyte count, and serum phosphate) were evaluated at two weeks and one month postpartum.

RESULTS

A total of 91 patients met the inclusion criteria (38 in the conventional treatment group and 53 in the FDI group). Hb levels were significantly higher and anemia rates significantly lower in the FDI group at both two weeks and one month postpartum. Serum iron and ferritin levels were also significantly higher in the FDI group. No cases of hypophosphatemia were observed in either group.

CONCLUSION

Single-dose intravenous FDI demonstrated earlier and more effective correction of postpartum anemia compared with conventional treatment, with a favorable safety profile. FDI may represent a strong treatment option in real-world clinical practice.