Further Observations on the Relation between Iron and Folate Status in Pregnancy

Iron supplementation compliance among pregnant women in Bicol, Philippines

“…Given that women who were warned of side-effects appeared to experience them more frequently, and that those who experienced side-effects were less likely to consume the supplements, it may be possible to improve health outcomes by encouraging doctors and midwives to emphasise that unwanted sideeffects are possibly due to the pregnancy itself, as opposed to the supplements, and that side-effects experienced from taking supplements are generally mild and subside with time 19 . Further study is needed regarding the utility of warning women about possible side-effects, and the best means of doing so.…”

The prevalence of anaemia depends on the definition: an example from the Aboriginal Birth Cohort Study

“…Although iron-deficiency anemia during pregnancy is associated with preterm delivery and delivering a low-birthweight baby (38 ), well designed, randomized control trials are needed to evaluate the effectiveness of universal iron supplementation on mitigating adverse birth outcomes. Some studies have indicated that adequate iron supplementation during pregnancy reduces the prevalence of irondeficiency anemia (6,10,(39)(40)(41)(42)66,104 ), but over the last few decades, the recommendation by the Council on Foods and Nutrition and other groups to supplement iron intake during pregnancy has not resulted in a reduced prevalence of anemia among low-income, pregnant women (4,9,105 ). Evidence on iron supplement use is limited, however, so it is not known how well the recommendation has been followed.…”

“…Low-dose supplementation regimens that meet pregnancy requirements (i.e., 30 mg iron/day) (46 ) and reduce unwanted side effects are as effective as higher dose regimens (i.e., 60 or 120 mg iron/day) in preventing irondeficiency anemia (66 ). Simplified dose schedules (e.g., 1 dose/day) may also improve compliance (65 ).…”

“…Evidence on iron supplement use is limited, however, so it is not known how well the recommendation has been followed. Conclusive evidence of the benefits of universal iron supplementation for all women is lacking, but CDC advocates universal iron supplementation for pregnant women because a large proportion of women have difficulty maintaining iron stores during pregnancy and are at risk for anemia (6,18,63 ), iron-deficiency anemia during pregnancy is associated with adverse outcomes (38 ), and supplementation during pregnancy is not associated with important health risks (10,65,66 ).…”

“…In the United States, the main reasons for lack of a recommended iron supplementation regimen during pregnancy may include lack of health-care provider and patient perceptions that iron supplements improve maternal and infant outcomes (65 ), com-plicated dose schedules (5,65 ), and uncomfortable side effects (e.g., constipation, nausea, and vomiting) (66,67 ). Low-dose supplementation regimens that meet pregnancy requirements (i.e., 30 mg iron/day) (46 ) and reduce unwanted side effects are as effective as higher dose regimens (i.e., 60 or 120 mg iron/day) in preventing irondeficiency anemia (66 ).…”