Trends in Digital Health Education for Iron Supplementation During Pregnancy (2010-2025): A Bibliometric Study

Introduction: Digital transformation has emerged as a pivotal factor in modernizing health systems and education worldwide. Despite its transformative potential, disparities in access to technology and digital education persist, particularly in low- and middle-income countries, impacting the preparation of future healthcare professionals. Aim: To explore the current gaps, challenges, and opportunities in the integration of digital technologies within health education to drive innovation and prepare future professionals for a digitally advanced healthcare landscape. Methods: A brief bibliometric analysis was conducted using Scopus to assess global and Latin American research trends in digital health and professional health education. Results: Global research on digital health has shown exponential growth since 2016, with the United States and United Kingdom leading production. In Latin America, research remains limited, accounting for only 3.13% of global output. Brazil leads regional efforts, though disparities in institutional contributions and technological access are evident. Digital health education is still a niche, with less than 300 global publications and only 16 originating from Latin America. Conclusions: Innovation and digital transformation in health education present unique opportunities to address global disparities and prepare healthcare professionals for emerging challenges. Strengthening technological infrastructure, integrating digital competencies into curricula, and fostering international collaborations are critical to achieving equitable advancements in health education.

Background Iron deficiency anemia (IDA) remains a significant public health challenge in Indonesia, particularly in pregnant women and female adolescents. The Indonesian government has implemented several prevention and management programs, such as providing iron-folic acid tablets to female adolescents and pregnant women, initiating early health promotion to infants and pregnant women, conducting nutritional education to pregnant women, and providing supplementary feeding to pregnant women. However, the prevalence of iron deficiency anemia (IDA) in these groups remains significant and some of the strategies haven’t been successfully and effectively implemented. Stemming from this issue and gaps, qualitative insights and opinions from relevant experts are crucial for the improvement of iron deficiency anemia (IDA) prevention and management strategies in Indonesia. Objectives This qualitative study discussed the expert opinions regarding iron deficiency anemia (IDA) prevention and management strategies in Indonesia. Methods A qualitative study on expert opinions regarding iron deficiency anemia (IDA) involving 11 participants selected through purposive sampling among those who have expertise in women’s and children’s health, nutrition, clinical psychology, and education in a 90-minute online Focus Group Discussion (FGD) was done. The main themes identified were the importance and urgency of iron deficiency anemia (IDA) status assessment, behavior modification-oriented health education, and iron deficiency anemia (IDA) prevention in pregnant women and female adolescents. Data were transcribed and analyzed using NVIVO 12. Results The key recommendations from the experts' discussion for a holistic approach to prevent and manage iron deficiency anemia (IDA) in Indonesian pregnant women and female adolescents were: (1) By emphasizing iron deficiency anemia (IDA) status assessment prior to supplementation with ferritin test as indicators, hoping that the targets can be detected and receive interventions as early and accurately as possible. (2) Behavior modification-oriented health education by analyzing the target's level of knowledge and comprehension of iron deficiency anemia (IDA), potential challenges, and factors that can encourage preventive behavior against iron deficiency anemia (IDA), implementing preventive measures against iron deficiency anemia (IDA) and supportive social environments, and providing health education with the involvement of supportive social environments. (3) Iron deficiency anemia (IDA) prevention strategies in pregnant women and female adolescents by consumption of foods rich in iron and/or rich in iron enhancers, as well as avoiding foods that contain iron inhibitors and the iron-folic acid tablets consumption adherence. Conclusion Effective iron deficiency anemia (IDA) prevention and management strategies include ferritin-based iron status assessment prior to supplementation, behavior modification-oriented health education, dietary interventions, and iron supplementation adherence. Nevertheless, the government’s commitment to support and fund the programs is also crucial in order to achieve the desired outcomes.

More Effective Route of Treatment for Iron Deficiency Anemia in Pregnancy Intravenous Vs Oral Iron

Iron Requirements for Infants with Cow Milk Protein Allergy

This review focuses on the occurrence, prevention and treatment of anaemia during pregnancy in Western societies. Iron deficiency anaemia (IDA) is the most prevalent deficiency disorder and the most frequent form of anaemia in pregnant women. Minor causes of anaemia are folate and vitamin B12 deficiency, haemoglobinopathy and haemolytic anaemia. Anaemia is defined as haemoglobin of <110 g/L in the first and third trimester and <105 g/L in the second trimester. The diagnosis relies on haemoglobin, a full blood count and plasma ferritin, which can be supported by plasma transferrin saturation and serum soluble transferrin receptor. Among fertile, non-pregnant women, approximately 40% have ferritin of <or=30 microg/L, i.e. small or absent iron reserves and therefore an unfavourable iron status with respect to upcoming pregnancy. The prevalence of prepartum anaemia in the third trimester ranges 14-52% in women taking placebo and 0-25% in women taking iron supplements, dependent on the doses of iron. In studies incorporating serum ferritin, the frequency of IDA in placebo-treated women ranges 12-17% and in iron-supplemented women 0-3%. Requirements for absorbed iron increase during pregnancy from 0.8 mg/day in the first trimester to 7.5 mg/day in the third trimester, on the average approximately 4.4 mg/day, and dietary measures are inadequate to reduce the frequency of prepartum IDA. However, IDA is efficiently prevented by oral iron supplements in doses of 30-40 mg ferrous iron taken between meals from early pregnancy to delivery. Treatment of IDA should aim at replenishing body iron deficits by oral and/or intravenous administration of iron. In women with slight to moderate IDA, i.e. haemoglobin of 90-105 g/L, treatment with oral ferrous iron of approximately 100 mg/day between meals is the therapeutic option in the first and second trimester; haemoglobin should be checked after 2 weeks and provided an increase of >or=10 g/L, oral iron therapy has proved effective and should continue. Treatment with intravenous iron is superior to oral iron with respect to the haematological response. Intravenous iron is considered safe in the second and third trimester, while there is little experience in the first trimester. Intravenous iron of 600-1,200 mg should be considered: (1) as second option if oral iron fails to increase haemoglobin within 2 weeks; (2) as first option at profound IDA, i.e. haemoglobin of <90 g/L in any trimester beyond 14 weeks gestation; and (3) as first option for IDA in third trimester. Profound IDA has serious consequences for both woman and foetus and requires prompt intervention with intravenous iron. This is especially important for the safety of women who for various reasons oppose blood transfusions.

Rethinking anaemia surveillance

Introduction: Anaemia is one of the most common nutrition deficiency disorders affecting pregnant women. During pregnancy they need for iron for mother and foetus gradually increases and will reach its highest level at the end of pregnancy. Poor dietary practice and low compliance to iron tablets among pregnant women are major contributors for high burden of anaemia. They should be awareness of anaemia among antenatal women and association of knowledge, attitude and practice of Nutrition during pregnancy and taking iron-rich food. Objectives: To assess the knowledge, attitude and practice regarding anaemia in antenatal women. Material &amp; Methods: It was a prospective study conducted in the department of Obstetrics and Gynaecology, Kurnool Medical College and Hospital, Kurnool ,Andhra Pradesh over a period of 3 month from November 1st 2022 to January 31st 2023. Data was collected by using a structured and Pretested questionnaire which asked question on nutrition in pregnancy,anaemia and associated factors. Results: A total of 500 antenatal women, 344 of them had heard about iron deficiency anaemia, 304 of them know that poor nutrition causes the anaemia during pregnancy , 192 agreed that iron supplement or iron tablets can prevent anaemia, 201 of them dont know that spacing of pregnancies can prevent anaemia ,331 have not taken a regular iron tablets. The study reflects the ignorance, poverty and illiteracy among majority of the child bearing women coming to the Hospital. Conclusion: Assessments of knowledge and practice and health education are essential step towards prevention of anaemia in pregnancy. Educating antenatal women about the importance of diet and implementing this into practice will help in the prevention of anaemia.

Background: Pregnant women are at a high risk of iron deficiency anaemia in Ghana. Despite the provision of iron nutrition education and supplementation for the prevention of iron deficiency anaemia in pregnancy, the estimated prevalence of iron deficiency anaemia in pregnancy is relatively high. The associated factors such as maternal knowledge of iron nutrition and supplementation therapy are not clear due to limited data. Objective: This study aims to assess maternal knowledge of iron nutrition and supplementation and associated factors in the rural Tain District of Ghana. Method: Cross-sectional quantitative data was used. Data was collected from a sample of 480 pregnant women attending antenatal clinics in any of the health facilities in the Tain district. The ten health facilities were stratified and the allocation of samples to each of the ten facilities was proportionate to size. Simple random sampling was used to select individual participants from a compiled list of registered antenatal mothers in each health facility. Results: In all, 36% of participants reported having adequate knowledge of iron nutrition and supplementation. Pregnant women whose husbands have no formal/Primary education (AOR=0.0078(95% CI: 0.021, 0.294), Middle/JHS education (AOR=0.223(95% CI: 0.067, 0.743) were associated with a knowledge of iron nutrition and supplementation. Pregnant women who have one child (AOR= 0.150 (95% CI: 0.053, 0.426) and those who have two children (AOR= 0.375(95% CI: 0.146, 0.963) had lower odds of adequate knowledge of iron nutrition and supplementation. Conclusion: Maternal knowledge of iron nutrition and supplementation for the prevention of iron deficiency anaemia is low. Health education on iron nutrition and supplementation therapy should be strengthened.

Multidisciplinary Implementation of an Iron Deficiency Anemia in Pregnancy Treatment Protocol

The Impact of Intravenous Iron on Renal Injury and Function Markers in Patients With Chronic Kidney Disease and Iron Deficiency Without Anemia

Background: Iron deficiency anemia (IDA) remains one of the most prevalent nutritional disorders globally, particularly affecting pregnant women in low- and middle-income countries. While oral iron is the standard first-line treatment, its gastrointestinal side effects and poor compliance often limit effectiveness. Intravenous (IV) iron offers a faster alternative but carries potential risks and higher costs. Objective: To systematically compare the efficacy and safety of intravenous iron therapy versus oral iron supplementation for treating iron deficiency anemia in pregnant women, based on randomized controlled trial (RCT) data. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases including PubMed, Cochrane CENTRAL, and Google Scholar were searched from inception to 15 March 2025 for RCTs comparing IV and oral iron in pregnant women with IDA. Outcomes included change in hemoglobin (Hb) levels, risk of postpartum hemorrhage (PPH), need for blood transfusion, and adverse events. Risk of bias was assessed using the Cochrane Risk of Bias Tool, and evidence certainty was graded using GRADE. A random-effects model was used to pool results. Results: Ten RCTs (n = 5954) were included. IV iron was associated with a significantly greater Hb increase at 3–6 weeks post-treatment (SMD: 0.25; 95% CI: 0.01–0.49; P = 0.04; I² = 85%). Sensitivity analysis excluding high-weight studies showed stronger results (WMD: 0.36 g/dL; 95% CI: 0.24–0.47; P &lt; 0.00001; I² = 27%). No significant difference was found in the risk of PPH (RR: 1.21; 95% CI: 0.77–1.89; P = 0.41) or need for transfusion (RR: 0.69; 95% CI: 0.46–1.03; P = 0.07). Adverse events were significantly lower in the IV iron group (RR: 0.51; 95% CI: 0.37–0.71; P &lt; 0.0001; I² = 0%). Conclusion: IV iron is more effective than oral iron for improving hemoglobin levels in pregnant women with IDA and has a better safety profile. However, it does not significantly reduce the risk of PPH or transfusion. These findings support the selective use of IV iron in clinical scenarios where oral iron is poorly tolerated or ineffective. Further research is needed to evaluate long-term maternal and neonatal outcomes and cost-effectiveness in resource-limited settings.

Anaemia during pregnancy is a serious public health problem, inequitably burdening women in low-and middle-income countries. Despite numerous strategies and programs, anaemia prevalence rates have stagnated. We aimed to explore women's, health workers', and other key stakeholders' perceptions of anaemia in pregnant women, or their experiences with its prevention, testing, or treatment. We conducted a qualitative evidence synthesis. We searched MEDLINE (Ovid), Scopus, and CINAHL from inception to 12 November 2024, with no language or geographical restrictions. Data were analysed using thematic synthesis, and confidence in each review finding was assessed using the GRADE-CERQual approach. We included 61 papers from 23 countries. We grouped 25 review findings under four themes: (a) socio-cultural context of anaemia in pregnant women; (b) prevention and/or treatment of anaemia in pregnant women through diet, supplementation, or clinical intervention; (c) testing pregnant women for anaemia; and (d) factors affecting health workers' engagement in the management of anaemia in pregnant women. Women's management of anaemia in pregnancy was affected by the socio-cultural context, particularly their limited decision-making power and social position. Many women perceived a nutritious diet as integral to managing anaemia; however, high cost was often a barrier. Reasons women did not adhere to supplements included side-effects and difficulty remembering to take them, with family support improving adherence. Blood transfusion was perceived as treatment for severe anaemia, while intravenous iron was considered for women with iron-deficiency anaemia who were unable to take supplements, attended antenatal care late, or could not receive a transfusion. Health workers described difficulties testing pregnant women for anaemia and structural health-system deficiencies that affected their engagement. Findings may inform future WHO recommendations for managing anaemia in pregnant women. Future research could use review findings alongside implementation science frameworks to develop strategies for improving prevention, testing, and/or treatment of anaemia in pregnant women.

Anaemia during pregnancy is a serious public health problem, inequitably burdening women in low-and middle-income countries. Despite numerous strategies and programs, anaemia prevalence rates have stagnated. We aimed to explore women’s, health workers’, and other key stakeholders’ perceptions of anaemia in pregnant women, or their experiences with its prevention, testing, or treatment. We conducted a qualitative evidence synthesis. We searched MEDLINE (Ovid), Scopus, and CINAHL from inception to 12 November 2024, with no language or geographical restrictions. Data were analysed using thematic synthesis, and confidence in each review finding was assessed using the GRADE-CERQual approach. We included 61 papers from 23 countries. We grouped 25 review findings under four themes: (a) socio-cultural context of anaemia in pregnant women; (b) prevention and/or treatment of anaemia in pregnant women through diet, supplementation, or clinical intervention; (c) testing pregnant women for anaemia; and (d) factors affecting health workers’ engagement in the management of anaemia in pregnant women. Women’s management of anaemia in pregnancy was affected by the socio-cultural context, particularly their limited decision-making power and social position. Many women perceived a nutritious diet as integral to managing anaemia; however, high cost was often a barrier. Reasons women did not adhere to supplements included side-effects and difficulty remembering to take them, with family support improving adherence. Blood transfusion was perceived as treatment for severe anaemia, while intravenous iron was considered for women with iron-deficiency anaemia who were unable to take supplements, attended antenatal care late, or could not receive a transfusion. Health workers described difficulties testing pregnant women for anaemia and structural health-system deficiencies that affected their engagement. Findings may inform future WHO recommendations for managing anaemia in pregnant women. Future research could use review findings alongside implementation science frameworks to develop strategies for improving prevention, testing, and/or treatment of anaemia in pregnant women.

Introduction: Anemia is a global health issue that predominantly affects women of reproductive age. The World Health Organization has implemented an iron supplementation program that various countries, including India, have adopted. Despite numerous anemia prevention strategies, the incidence of anemia remains high. This study aims to assess pregnant women’s compliance with iron and folic acid supplementation and identify the factors influencing this compliance. Methodology: This cross-sectional study was conducted among pregnant women at a rural medical college. The study utilized a questionnaire based on the Morisky Medication Adherence Scale to categorize the participants into compliant and noncompliant groups. Both groups were interviewed using a standardized questionnaire to gather information on their sociodemographic profiles, obstetric history, anemia awareness, iron supplementation during pregnancy, and healthcare needs. The data were organized in Microsoft Excel and analyzed using appropriate statistical methods. Results: The study sample comprised 460 participants, with 182 women (39.56%) classified as compliant. The compliant group demonstrated significantly better educational and a higher socioeconomic status than the noncompliant group. In terms of obstetric factors, women in the compliant group had substantially more antenatal care visits, earlier registration in the first trimester, longer interconception intervals, and higher contraceptive use rates. Moreover, the compliant group showed greater knowledge and awareness of iron supplementation, anemia prevention, and healthcare needs during pregnancy. Conclusion: This study highlights that compliance with iron and folic acid supplementation among rural pregnant women remains low, with women’s education and awareness being key factors influencing adherence. In addition to ongoing efforts in the Anemia Mukt Bharat Programme, introducing prophylactic parenteral iron supplementation may enhance compliance and reduce anemia.

Iron deficiency anemia (IDA) is a significant global health problem, with negative impacts on the health of pregnant women, fetuses, and newborns, including the risk of complications such as preterm birth and low birth weight. Midwives play an important role in the prevention and early detection of IDA through education, nutritional counseling, and routine screening, in accordance with international guidelines that need to be adjusted to the local context and capacity of the health system in each country. This study aims to explore the role of midwives in the prevention and early detection of iron deficiency anemia (IDA) in pregnant women by referring to international guidelines, best practices, and the latest scientific evidence. The results of the revoew aims to discuss that the role of midwives in the prevention and screening of Iron Deficiency Anemia (IDA) is very important as the main service provider during pregnancy and childbirth. By utilizing international guidelines, midwives can improve understanding of effective screening techniques and IDA prevention strategies, such as early identification, iron supplementation, and education for pregnant women. Evidence-based practices implemented by midwives can improve maternal and fetal health and reduce the prevalence of maternal mortality (MMR).