Abstract
Background: Anaemia and iron-deficiency anaemia in women are global problems that are prevalent throughout the reproductive cycle. Data are scarce on whether iron supplementation in pregnancy and puerperium has a sustained effect on haemoglobin concentration. Objective: To assess whether there is a dose effect of iron supplementation in pregnancy and puerperium on haemoglobin 6 weeks after delivery, and compare the effectiveness of daily and weekly dose regimens at 6 weeks postpartum. Design: 50 antenatal centres were assigned randomly to 1×60 mg iron daily or 2×60 mg once weekly. Data are reported for 146 women (daily, n=67; weekly, n=79): haemoglobin, serum ferritin (sFt) and serum transferrin receptors (sTfR) at baseline and at 6 weeks postpartum. Tablet intake was monitored using pill-bottles equipped with electronic counting devices. Results: There was a dose effect of iron supplementation on haemoglobin concentration at 6 weeks postpartum. Endpoint attaine d haemoglobin, sFt and sTfR did not differ between daily and weekly groups, although a larger increment of sFt was found in the daily group (p=0.03). Conclusions: Effects of iron supplementation in pregnancy and puerperium were observed at 6 weeks after delivery. The size of the effect was dependent on the number of tablets, not on daily or weekly regimen. It is not known whether the effects of iron supplementation in pregnancy are sustained into the next pregnancy. Keywords: Bangladesh, haemoglobin, iron status, iron supplementation, pregnancy, puerperium.
Highlights
Anaemia has the highest prevalence during pregnancy, it is common throughout the reproductive cycle [1,2,3]
Data are reported on 146 women who had complete information on intake of iron tablets during weeks 1–4 and haemoglobin concentration, serum ferritin (sFt) and serum transferrin receptors (sTfR) at baseline and at 6 weeks postpartum (Table 1)
Among women included in the analyses there was no difference in the baseline characteristics, except that sFt was higher in the weekly group (p = 0.06)
Summary
Anaemia has the highest prevalence during pregnancy, it is common throughout the reproductive cycle [1,2,3]. To increase the programme effectiveness, an intermittent dose frequency of iron supplementation has been suggested [10], resulting in a number of field trials to test the efficacy and effectiveness of weekly regimens. These trials compared the effect of iron supplementation in daily versus weekly regimens in different population groups, including pregnant women [11,12,13]. Objecti7e: To assess whether there is a dose effect of iron supplementation in pregnancy and puerperium on haemoglobin 6 weeks after delivery, and compare the effectiveness of daily and weekly dose regimens at 6 weeks postpartum. It is not known whether the effects of iron supplementation in pregnancy are sustained into the pregnancy
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