Effect of daily versus intermittent iron therapy in pregnant women: hematological and pregnancy outcome

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Background: The purpose of this study was to compare daily iron supplementation and intermittent iron supplementation in preventing anemia in healthy pregnant women. Material and Method: Prospective Randomized Clinical Trial. From May 2004 – December 2006, 141 healthy pregnant women without anemia, between 14 - 20 weeks of pregnancy were randomly allocated into two equal groups. Completed data were obtained in 110 patients, 55 in each group. The first group (n = 55) received a 100 mg-ferrous sulfate tablet daily, the second group (n = 55) received a 100 mg-ferrous sulfate tablet two tablets once weekly, respectively till delivery. Serum hemoglobin, ferritin, and iron were measured before and after the supplementation. Paired t and ANOVA tests were used as appropriate. Results: There were no significant differences between the pre- and post-treatment hemoglobin levels (p= 0.871) and serum ferritin levels (p= 0.741) with iron supplementation in the two groups when the maternal hemoglobin level was >11g/dL before enrolment. However, For those women who had a hemoglobin concentration <11gm/dL at the beginning, the rise in hemoglobin concentration was significantly greater at the end in the daily supplemented group as compared to the weekly group (1.44±1.51 gm/dl vs. 0.12±1.05 gm/dl, p=0.015). Although when the changes in the serum ferritin level which occurred in each group were compared, there was no significant difference (p=0.415) between the two intervention groups. Conclusions: These results suggest, daily or weekly iron supplementation is equally effective for healthy pregnant women without anemia.