Comment: The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment, incomplete outcome data, and selective reporting in half of the trials, and no blinding).
A Cochrane review [Abstract] 1 included 21 studies with a total of 5490 women. All of these studies compared daily versus intermittent iron supplementation. Three studies provided iron alone, 14 iron plus folic acid and 4 more iron plus multiple vitamins and minerals. Overall, there was no clear evidence of differences between groups for infant primary outcomes: low birthweight (RR 0.82; 95% CI 0.55 to 1.228 studies, n=1898), infant birthweight (mean difference MD 5.13 g, 95% CI -29.46 to 39.729 studies, n=1939), premature birth (average RR 1.03; 95% CI 0.76 to 1.39; 5 studies, n=1177). None of the studies reported neonatal deaths or congenital anomalies.For maternal outcomes, there was no clear evidence of differences between groups for anaemia at term (average RR 1.22; 95% CI 0.84 to 1.80; 4 studies, n=676) and women receiving intermittent supplementation had less side effects (average RR 0.56; 95% CI 0.37 to 0.84; 11 studies, n=1777) than those receiving daily supplements. Women receiving intermittent supplements were also at lower risk of having high haemoglobin concentrations (greater than 130 g/L) during the second or third trimester of pregnancy.
Date of latest search:31 July 2015
Primary/Secondary Keywords