Evaluation of the effectiveness of iron and folate supplementation during pregnancy in a rural area of Limpopo province

Abstract

Objective. To evaluate the effectiveness of iron and folate supplementation in antenatal clinics.Design. A cross-sectional analytical study.Setting. Villages in the central region of Limpopo province, which are serviced by Mankweng Hospital.Subjects. Third-trimester pregnant women (N = 262) attending antenatal clinics at eight local clinics inthe villages.Results. The prevalence of anaemia (haemoglobin < 10.5 g/dl) in this study population was 16.4%. The mean number of clinic visits during pregnancy was 4.1 (standard deviation (SD) 2.18). There were no differences in clinic attendance for the anaemic and non-anaemic participants. Maternal weight was found to be lower (p = 0.051) in the anaemic than the non-anaemic group. Iron, vitamin B12 and folate deficiencies are still common in this area, with 50.9%, 16.4% and 10.3% of the pregnant women respectively having biochemical evidence of these deficiencies. In the anaemic group iron deficiency was the most prevalent deficiency, with 62.8% of the women having iron deficiency (serum ferritin < 12 5g/ml). In the non-anaemic group there was a significant negative correlation between both serum and red cell folate and the time of first visit to the clinic, indicating that folate supplementation given by the clinics is effective in prevention of folate deficiency.Conclusion. Although both iron and folate supplements are issued at antenatal clinics in the central area of Limpopo province, iron deficiency and iron deficiency anaemia are still prevalent in pregnant women. However there has been a marked improvement in the prevalence of folate deficiency.