Iron supplementation during pregnancy

Abstract

192 pregnant women were consecutively randomized to either a vitamin-mineral pill or a vitamin mineral pill with a high iron content in a prospective, open, randomized investigation. The participants were advised about iron-rich foodstuffs twice during pregnancy. Iron status of the mother proved to be without any significance for the outcome of pregnancy. A serum ferritin level of 80 pmol/l in mid-pregnancy followed by a control in the last trimester was suggested as a guide in deciding of whether or not to prescribe supplementary iron during pregnancy.

Low dose iron supplementation does not cover the need for iron during pregnancy

“…Thus, despite a compensatory increase in the net absorption of iron during the third trimester, there is a theoretical iron deficit during pregnancy at the size of or larger than the average iron stores in fertile women. This is in agreement with studies showing that pregnant women, who do not receive iron supplementation, empty their iron stores (8,9,10) and experience a smaller increase in the red cell mass, than pregnant women receiving prophylactic iron supplementation (1 1). Despite this, the clinical benefit and a positive effect of iron supplementation on the course of pregnancy is not proven (12).…”

Daily oral iron supplementation during pregnancy

“…In 44 trials women received different types of iron (for example ferrous iron versus iron fumarate), or women received iron with or without other vitamins or supplements (Afifi 1978; Babior 1985; Balmelli 1974; Burslem 1968; Buss 1981; Carrasco 1962; Castren 1968; Chanarin 1968; Coelho 2000; Dawson 1987; Dijkhuizen 2004; Ekstrom 1996; Fletcher 1971; Giles 1971; Gringras 1982; Hartman-Craven 2009; Hosokawa 1989; Kaestel 2005; Kann 1988; Lira 1989; Ma 2008; Mbaye 2006; Metz 1965; Morrison 1977; Nogueira 2002; Ogunbode 1984; Ogunbode 1992; Osrin 2005; Payne 1968; Rae 1970; Ramakrishnan 2003; Rayado 1997; Rolschau 1979; Roth 1980; Rybo 1971; Saha 2007; Shatrugna 1999; Sjostedt 1977; Srisupandit 1983; Stone 1975; Trigg 1976; Weil 1977; Willoughby 1966; Willoughby 1968). In 34 trials both groups received iron and either different doses of iron were compared (Aaseth 2001; Ahn 2006; Brown 1972; Guldholt 1991; Horgan 1966; Madan 1999; Milman 2005; Nguyen 2008; Reddaiah 1989; Thane-Toe 1982; Thomsen 1993; Vogel 1963; Zhou 2009), or different types of regimen (for example daily versus weekly iron) (Bhatla 2009; Casanueva 2003a; Chew 1996a; Chew 1996b; Ekstrom 2002; Gomber 2002; Goonewardene 2001; Grover 1998; Liu 1996; Mukhopadhyay 2004; Mumtaz 2000; Pena-Rosas 2003; Pita Martin 1999; Quintero 2004; Ridwan 1996; …”

“…In 34 trials both groups received iron and either different doses of iron were compared (Aaseth 2001; Ahn 2006; Brown 1972; Guldholt 1991; Horgan 1966; Madan 1999; Milman 2005; Nguyen 2008; Reddaiah 1989; Thane-Toe 1982; Thomsen 1993; Vogel 1963; Zhou 2009), or different types of regimen (for example daily versus weekly iron) (Bhatla 2009; Casanueva 2003a; Chew 1996a; Chew 1996b; Ekstrom 2002; Gomber 2002; Goonewardene 2001; Grover 1998; Liu 1996; Mukhopadhyay 2004; Mumtaz 2000; Pena-Rosas 2003; Pita Martin 1999; Quintero 2004; Ridwan 1996; Robinson 1998; Winichagoon 2003; Yecta 2011; Young 2000; Yu 1998; Zamani 2008). (Daily versus intermittent oral iron regimens in pregnancy are examined in a related Cochrane review (Pena-Rosas 2012).…”

Intermittent oral iron supplementation during pregnancy

“…Psychometric tests (arithmetic, total digit span, digit symbol, vocabulary and others) were performed and hematologic status was measured at baseline and after a month. Hematologic outcomes cannot be extracted from the paper.None of the other outcomes were sought Guldholt 1991 192 pregnant women were consecutively randomised to receive one of two treatments: group 1: received a daily vitamin-mineral tablet containing 15 mg of elemental iron or group 2: received a daily vitamin-mineral tablet containing 100 mg of elemental iron. Both groups received iron in different doses.…”