Daily Versus Weekly Oral Iron Supplementation in Pregnant Women (A Randomized Co¬ntrolled Clinical Trial)

Abstract

Background: High doses of iron lead to gastrointestinal intolerance suggesting some toxic effect on the gut mucosa that is probably mediated by iron-related oxidative stress. Aim of this Work: to compare the hemoglobin levels in non anemic pregnant women receiving weekly versus daily iron supplementation. Patients and Methods: This randomized controlled clinical trial was conducted One hundred and forty patients during the period from October 20017 to December 2018 at Ain-Shams University Maternity hospital in the outpatient antenatal clinics. They were divided into two groups: Group A: (weekly group) received 2 capsules of 100 mg elemental iron (from 305mg ferrous fumarate) plus 2 mg of folic acid (Ferro — 6 - Pharco - Egypt) once weekly. Group B: (daily group) received one capsule of 100 mg elemental iron (from 305mg ferrous fumarate) plus 2 mg of folic acid (Ferro - 6 - Pharco - Egypt) once daily. Results: There was no statistically significant difference could be detected between both groups as regards the demographic data, body mass index, interval since last pregnancy, hemoglobin level before starting iron supplementation and duration of supplementation and this can be attributed to proper randomization. In this study, there was no statistically significant difference between both groups as regards the hemoglobin level after one month of iron supplementation and after three months of iron supplementation. Although the mean hemoglobin concentration at 36 weeks gestation was lower in the weekly supplementation group it did not reach the level of statistical significance. There was significant increase in the incidence of iron side-effects mainly gastrointestinal side-effects in the form of nausea, vomiting, constipation, heart burn and metallic taste. High doses of iron lead to gastrointestinal intolerance. There was no statistically significant difference could be detected between both groups as regards the fetal weight. Conclusion: weekly iron supplementation as a prophylaxis in non-anemic pregnant women is as good as daily supplementation as regards the hemoglobin level in addition; it was associated with significantly fewer side-effects and much better compliance.