Randomized control trial comparing effectiveness of weekly versus daily antenatal oral iron supplementation in preventing anemia during pregnancy.

Abstract

This study was conducted to determine whether weekly antenatal oral iron and folate supplementation is an effective alternative to a daily regimen in non-anemic pregnant women to prevent anemia and iron deficiency during the third trimester. From December 2014 to April 2015, non-anemic pregnant women (n = 292) who presented to the Academic Obstetric Unit, Teaching Hospital Mahamodera Galle, Sri Lanka, at 14-22 weeks gestation and who had been treated with mebendazole 100 mg twice daily for three days were randomly allocated to receive 120 mg elemental iron, 3 mg folic acid and 100 mg vitamin C weekly (n = 149) or 60 mg elemental iron, 1 mg folic acid and 100 mg vitamin C daily (n = 143). Side effects were assessed at four weekly intervals and hemoglobin concentration (Hb), hematocrit and serum ferritin (SF) were measured at 32-36 weeks gestation. Only 106 participants in each group completed the study. There were no significant differences between the groups in mean duration of supplementation; presupplementation and post-supplementation mean Hb, hematocrit or SF levels; risk of developing anemia, ID or high Hb levels by an intension to treat analysis; and in those who completed the trial. Significantly greater side effects occurred in the daily compared to the weekly supplementation group. In non-anemic pregnant women, a weekly regimen is an effective alternative to a daily regimen for antenatal oral iron and folate supplementation for preventing anemia and iron deficiency during the third trimester.