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Evidence summaries

Intermittent Oral Iron Supplementation during Pregnancy

Intermittent iron plus folic acid regimens may possibly produce similar maternal and infant outcomes at birth as daily supplementation in pregnant women without anaemia, but are associated with fewer side effects. Level of evidence: "C"

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).

Summary

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

References

  • Peña-Rosas JP, De-Regil LM, Dowswell T et al. Intermittent oral iron supplementation during pregnancy. Cochrane Database Syst Rev 2012;(7):CD009997 [Assessed as up-to-date: 31 July 2015]. [PubMed]

Primary/Secondary Keywords