Prophylaxis With Iron and Folate Supplementation in Pregnancy; A Health Facility-Based Assessment of Its Role for Prevention of Anaemia at Delivery

Abstract

Objective: Presumptive Iron and folate supplementation, (IFS), for both healthy and irondeficient pregnant women in developing countries, is aimed to ameliorate the high prevalence of maternal anaemia.1 This may be valuable only in selected women.13 Its role for averting maternal anaemia at delivery is therefore analysed.Methodology: The hospital-based cross-sectional study enrolled 413 ANC attendant parturients, exposed to IFS prior to delivery. Anaemia in pregnancy was classified by specifications of the Indian Council of Medical Research (ICMR) using maternal pre-deliveryhaemoglobin concentrations. Maternal haemoglobin concentrations and differential patterns of exposure to IFS were analysed across various maternal and environmental variables with epi info 3.5.4.Results: Parturients were mostly aged 25-34 years and largely exposed to IFS for ≥ 6 months during pregnancy. Anaemic parturients, (typically defined by lower maternal age), initiated ANC attendance later than non-anaemic parturients. Patterns of maternal anaemia varied insignificantly despite differential patterns of duration of IFS and subjectively assessed degree of compliance. Self-reported full compliance with IFS weakly correlated with higher maternal Hgb concentrations. Mean maternal Hgb concentrations remained consistent with mild anaemia irrespective of duration of IFS.Conclusion: Despite weak correlates between maternal anaemia and degree of compliance, the capacity of IFS to prevent mild, moderate or severe maternal anaemia remains unclear.Recommendation: Indiscriminate IFS for all pregnant women, regardless of their Hgb concentrations, should be reviewed while investigation of factors that may underlie maternal non-response to routine IFS should be prioritized.