Efficacy of weekly versus daily antenatal oral iron supplementation in preventing anemia during pregnancy: A randomized controlled trial

Abstract

Iron deficiency anemia is the most common micronutrient deficiency in the world today. It impacts the lives of millions of women and children contributing to poor cognitive development, increased maternal mortality and decreased work capacity. Yet with appropriate public health action, this form of micronutrient malnutrition can be brought under control, various interventions exist that are designed to prevent and correct iron deficiency anemia. Iron is a micronutrient essential for hemoglobin synthesis and several organ functions. Fe deficiency is the most widespread nutrient deficiency in the world, affecting more than 50% of all pregnant women in developing countries. It may lead to anemia, intrauterine growth retardation (IUGR), and small for gestational age fetuses. Folate is a water-soluble B vitamin that plays a major co-enzymatic role in carbon metabolism and in the synthesis of DNA, RNA and certain amino acids. Dietary folate deficiency is prevalent in developing countries. Deficiency may lead to congenital malformations (neural tube damage, orofacial clefts, cardiac anomalies), anemia and certain complications during pregnancy (spontaneous abortions, bleeding, pre-eclampsia, IUGR and abruptio- placentae). Low folate status may also cause hyperhomocystemia, hypercoagulability and venous thrombosis. After four months of self-monitored treatment at home hemoglobin and serum ferritin levels re-measured with assessment of side effects and compliance as reported by candidates in both groups. The results showed hemoglobin and serum ferritin levels elevation in both groups with non-significant difference between the two groups and better compliance in the weekly administration group showed by more commitment by women in this group to take their medications and lesser side effects in weekly group than daily one. Side effects reported were, nausea, vomiting, constipation and gastric upset which were more applied to the daily group than weekly supplementation group. Research in the near future, and international organizations, should perform the task to improve management of anemia worldwide, lowering costs of diagnostic tools in developing countries, finding new markers for iron states and revealing other relations between iron deficiency states and fetal–maternal complications.