How many women take oral supplementation in pregnancy in Austria? : Who recommended it? A cross-sectional study.

Ulrike Spary-Kainz,Thomas Semlitsch,Sophie Rundel,Heidelinde Jakse,Andrea Siebenhofer,Alexander Avian,Sereina Herzog

doi:10.1007/s00508-019-1502-9

Ulrike Spary-Kainz, Thomas Semlitsch + Show 5 more

Open Access

https://doi.org/10.1007/s00508-019-1502-9

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Abstract

SummaryBackgroundIron deficiency anemia is common in pregnancy with a prevalence of approximately 16% in Austria; however, international guideline recommendations on screening and subsequent treatment with iron preparations are inconsistent. The aim of this study was to find out how often pregnant women take iron-containing supplements, and who recommended them. As hemoglobin data were available for a sub-group of women, hemoglobin status during pregnancy and associated consumption of iron-containing medications were also recorded.MethodsThis cross-sectional study was conducted at the Mother-Child-Booklet service center of the Styrian Health Insurance Fund in Graz, Austria. A questionnaire containing seven questions was developed. Absolute and relative numbers were determined, and corresponding 95% confidence intervals calculated using bootstrapping techniques.ResultsA total of 325 women completed the questionnaire, 11% had been diagnosed with anemia before becoming pregnant, 67% reported taking iron-containing compounds. The women reported taking 45 different products but 61% took 1 of 3 different supplements. Overall, 185 (57%) women had not been diagnosed with anemia before becoming pregnant but reported taking an iron-containing supplement and 89% of the women took supplements on the recommendation of their physician. Of the 202 women whose hemoglobin status was assessed, 92% were found not to be anemic.ConclusionOverall, 67% of pregnant women took iron-containing compounds, irrespective of whether they were deficient in iron. Physicians were generally responsible for advising them to take them. No standardized procedure is available on which to base the decision whether to take iron during pregnancy, even in guidelines. As most guidelines only recommend taking iron supplements in cases of anemia, the high percentage of women taking them in Austria is incomprehensible.Electronic supplementary materialThe online version of this article (10.1007/s00508-019-1502-9) contains supplementary material, which is available to authorized users.

Highlights

Iron deficiency anemia is the most common form of anemia in pregnancy and is usually hypochromic and microcytic [1] and associated with a low level of ferritin
325 women completed the questionnaire. Of these 62.1% were over 30 years of age and it was the first pregnancy for 51.7%
10.8% (n = 35) of the women had been diagnosed with anemia before becoming pregnant, 33 were taking medication, of whom 6 were taking iron intravenously and 5 had changed their diet

Summary

Introduction

Iron deficiency anemia is the most common form of anemia in pregnancy and is usually hypochromic and microcytic [1] and associated with a low level of ferritin. According to the World Health Organization (WHO), its prevalence during pregnancy is approximately 15.5% in Austria [2]. 462 How many women take oral supplementation in pregnancy in Austria?. The definition of anemia varies during the course of pregnancy and is defined as a hemoglobin level < 11.0 mg/dl in the first trimester, 10.5 mg/dl in the second trimester and again 11 mg/dl in the third trimester [2]. Due to a paucity of evidence, one guideline [9] does not recommend anemia screening at all. There are huge differences in recommendations whether to take iron supplements

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