Doubling the Iron dose VS single dose Iron supplementation to prevent Iron Deficiency Anemia (IDA) in twin pregnant women: A Randomized Controlled Trial

Abstract

Iron deficiency anemia (IDA) is a very prevalent condition in pregnancy, affecting nearly 18% of all pregnant women during all three trimesters, with as many as 29%of women affected during the third trimester In twin pregnancies, the maternal iron demands are magnified, estimated at 1.8 times more than in singleton pregnancies due to greater maternal red blood cell mass and plasma volume expansion as well as increased fetal and placental requirements. Thus, maternal hemoglobin (Hgb) in multiple pregnancies is lower in all trimesters compared with singleton gestations, with a rate of IDA estimated to be 2.4 to even 4 times higher. Adverse outcomes of IDA, including low birth weights, intra-uterine growth restriction, preterm birth, delayed neurodevelopment status, and residual neonatal IDA are therefore also more common in twin pregnancies than in singletons. With the growing incidence of multifetal gestations this problem becomes even more pertinent. The recommendation of the US Institute of Medicine is that women bearing more than one fetus consume a daily supplement containing 30mg of elemental iron from the 12th week of gestation onward.