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Less iron during pregnancy appears as effective in preventing anemia
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Intermittent iron supplementation proved as effective at preventing anemia in pregnant women as daily intake, according to results of a systematic review.
Women who took iron supplements 1 to 3 days a week also experienced fewer side effects than those who took them every day, study results showed.
Anemia is common among women during pregnancy, and it has been known to increase risk of low birth weight, as well as delayed growth and development, according to background information in the study.
Daily supplements with iron and folic acid often are recommended as a preventative measure to raise hemoglobin levels in the blood. However, high hemoglobin levels have been associated with increased risk of premature birth and low/or low birth weight, according to background information in the study.
Juan Pablo Peña-Rosas, MD, coordinator of evidence and program guidance for the department of nutrition for health and development at WHO in Geneva, and colleagues undertook the current study to determine if intermittent supplementation offered similar benefits to daily intake and/or reduce side effects.
The researchers analyzed data from 18 trials that involved 4,072 pregnant women who took iron supplements alone, iron supplements with folic acid, or iron supplements with a multi-vitamin and mineral supplements.
The researchers determined women who took iron supplements once, twice or three times a week on non-consecutive days were no more likely to experience premature birth (RR=1.82; 95% CI, 0.75-4.4) or deliver a baby with low birth weight (RR=0.96; 95% CI, 0.61-1.52).
None of the studies reported neonatal death or congenital anomalies.
There was no evidence of differences between groups for anemia at term for mothers (RR=1.22; 95% CI, 0.84-1.8). Women who received intermittent supplementation had fewer adverse effects, such as nausea or constipation (RR=0.56; 95% CI, 0.37-0.84).
The women who received intermittent supplementation were at low risk for high concentrations of hemoglobin during their second and third trimester (RR=0.48; 95% CI, 0.35- 0.67), according to study results. The researchers also found no significant differences in iron deficiency anemia between women who received intermittent or daily iron and folic acid supplementation (RR=0.71; 95% CI, 0.08-6.63).
“Intermittent iron supplementation could be considered as a feasible alternative to daily supplementation for preventing anemia during pregnancy, particularly in developed countries where anemia in pregnancy is not a public health problem and there is good prenatal care for monitoring anemia status,” Peña-Rosas said in a press release.
Still, evidence remains limited, the researchers said. Additional studies are needed to clarify safe iron doses for expectant mothers and their effects on infants. Those studies should evaluate the health of newborns and infants from birth to 6 months of life or longer, the researchers said.
“It is important to evaluate new regimens to be able to respond to the need of the different countries that face different challenges in anemia prevention during pregnancy,” Peña-Rosas said.
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