Oral Iron Prophylaxis During Pregnancy‐a Comparative Study on Different Dosage Regimens

Abstract

The effect of oral iron prophylaxis on haemoglobin concentration (Hb) and haematocrit (Hct) has been studied in 300 pregnant women. From the 3rd to 4th month of pregnancy and until term the women were randomly treated with 100 mg or 200 mg ferrous iron daily respectively as sustained-release tablets (Duroferon Duretter ) or 200 mg ferrous iron as rapidly disintegrating tablets. All three treatments gave the same effect on Hb and Hct. This was true irrespective of the initial Hb. It was concluded that even the 100 mg dose was sufficient to cover the increased iron demands during pregnancy and to give an increase in Hb in anemic patients. The frequency of side-effects was lower in the two groups receiving the sustained-release tablets. The changes in Hb with time during pregnancy in relation to the initial iron status are discussed and some practical conclusions concerning the interpretation of the effect of iron supplementation during pregnancy are drawn.

The prevalence of anaemia depends on the definition: an example from the Aboriginal Birth Cohort Study

“…Evidence from randomized control trials indicates that iron supplementation decreases the incidence of iron-deficiency anemia during pregnancy (10,(39)(40)(41)(42), but trials of the effect of universal iron supplementation during pregnancy on adverse maternal and infant outcomes are inconclusive (10,43,44 ).…”

“…Among pregnant women, Hb concentration and Hct decline during the first and second trimesters because of an expanding blood volume (18,(39)(40)(41)(42). Among pregnant women who do not take iron supplements, Hb concentration and Hct remain low in the third trimester, and among pregnant women who have adequate iron intake, Hb concentration and Hct gradually rise during the third trimester toward the prepregnancy levels (39,40 ).…”

“…Among pregnant women who do not take iron supplements, Hb concentration and Hct remain low in the third trimester, and among pregnant women who have adequate iron intake, Hb concentration and Hct gradually rise during the third trimester toward the prepregnancy levels (39,40 ). Because adequate data are lacking in the United States, the cutoff values for anemia are based on clinical studies of European women who had taken iron supplementation during pregnancy (39)(40)(41)(42)72 ). For pregnant women, a test *Age-and sex-specific cutoff values for anemia are based on the 5th percentile from the third National Health and Nutrition Examination Survey (NHANES III), which excluded persons who had a high likelihood of iron deficiency by using the same methods described by Looker et al (45 ).…”

“…For pregnant women, a test *Age-and sex-specific cutoff values for anemia are based on the 5th percentile from the third National Health and Nutrition Examination Survey (NHANES III), which excluded persons who had a high likelihood of iron deficiency by using the same methods described by Looker et al (45 ). Maximum values for anemia during pregnancy are based on values from pregnant women who had adequate iron supplementation (39)(40)(41)(42)72 ). † Although no data are available from NHANES III to determine the maximum hemoglobin concentration and hematocrit values for anemia among infants, the values listed for children aged 1-<2 years can be used for infants aged 6-12 months.…”

“…Although iron-deficiency anemia during pregnancy is associated with preterm delivery and delivering a low-birthweight baby (38 ), well designed, randomized control trials are needed to evaluate the effectiveness of universal iron supplementation on mitigating adverse birth outcomes. Some studies have indicated that adequate iron supplementation during pregnancy reduces the prevalence of irondeficiency anemia (6,10,(39)(40)(41)(42)66,104 ), but over the last few decades, the recommendation by the Council on Foods and Nutrition and other groups to supplement iron intake during pregnancy has not resulted in a reduced prevalence of anemia among low-income, pregnant women (4,9,105 ). Evidence on iron supplement use is limited, however, so it is not known how well the recommendation has been followed.…”