Government-Industry Partnership in Weekly Iron-Folic Acid Supplementation for Women of Reproductive Age in the Philippines: Impact on Iron Status

Angeles‐Agdeppa, Imelda; Paulino, Lourdes S.; Ramos, Adelisa C.; Etorma, Unita Marie; Cavalli-Sforza, Tommaso; Milani, Silvano

doi:10.1111/j.1753-4887.2005.tb00157.x

Cited by 15 publications

(12 citation statements)

References 24 publications

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“…Careful examination of these studies resulted in the inclusion of 45 articles 20,23–66 most of which were based on observational studies (Table 1). The main reasons for excluding articles after completing abstraction were: (i) the intervention and/or exposure occurred after 12 weeks gestation, 67–74 (ii) missing our outcomes of interest, 75–83 and (iii) did not measure periconceptional exposures 84,85 …”

Section: Resultsmentioning

confidence: 99%

Effect of Women's Nutrition before and during Early Pregnancy on Maternal and Infant Outcomes: A Systematic Review

Ramakrishnan

Grant

Goldenberg³

et al. 2012

Paediatric Perinatal Epid

413

362

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Current understanding of biologic processes indicates that women's nutritional status before and during early pregnancy may play an important role in determining early developmental processes and ensuring successful pregnancy outcomes. We conducted a systematic review of the evidence for the impact of maternal nutrition before and during early pregnancy (<12 weeks gestation) on maternal, neonatal and child health outcomes and included 45 articles (nine intervention trials and 32 observational studies) that were identified through PubMed and EMBASE database searches and examining review articles. Intervention trials and observational studies show that periconceptional (<12 weeks gestation) folic acid supplementation significantly reduced the risk of neural tube defects. Observational studies suggest that preconceptional and periconceptional intake of vitamin and mineral supplements is associated with a reduced risk of delivering offspring who are low birthweight and/or small-forgestational age (SGA) and preterm deliveries (PTD). Some studies report that indicators of maternal prepregnancy size, low stature, underweight and overweight are associated with increased risks of PTD and SGA. The available data indicate the importance of women's nutrition prior to and during the first trimester of pregnancy, but there is a need for well-designed prospective studies and controlled trials in developing country settings that examine relationships with low birthweight, SGA, PTD, stillbirth and maternal and neonatal mortality. The knowledge gaps that need to be addressed include the evaluation of periconceptional interventions such as food supplements, multivitamin-mineral supplements and/or specific micronutrients (iron, zinc, iodine, vitamin B-6 and B-12) as well as the relationship between measures of prepregnancy body size and composition and maternal, neonatal and child health outcomes.

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Section: Resultsmentioning

confidence: 99%

Effect of Women's Nutrition before and during Early Pregnancy on Maternal and Infant Outcomes: A Systematic Review

Ramakrishnan

Grant

Goldenberg³

et al. 2012

Paediatric Perinatal Epid

413

362

View full text Add to dashboard Cite

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“…In Vietnam, mean Hb levels increased by 6.0 g/L in a cohort of non-pregnant women tested four times over twelve months [ 32 ]. In Cambodia increases in Hb levels were associated with higher socio-economic status in groups of schoolgirls, garment factory workers and rural women [ 33 ], and in the Philippines there was a significant increase in serum ferritin but minimal change in Hb [ 34 ]. Dwivedi et al (2006) reported a Government-sponsored community-based WIFS program targeted at adolescent girls in 13 Indian states.…”

Section: Discussionmentioning

confidence: 99%

A free weekly iron-folic acid supplementation and regular deworming program is associated with improved hemoglobin and iron status indicators in Vietnamese women

et al. 2009

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Background: Anemia due to iron deficiency is recognized as one of the major nutritional deficiencies in women and children in developing countries. Daily iron supplementation for pregnant women is recommended in many countries although there are few reports of these programs working efficiently or effectively. Weekly iron-folic acid supplementation (WIFS) and regular deworming treatment is recommended for non-pregnant women living in areas with high rates of anemia. Following a baseline survey to assess the prevalence of anemia, iron deficiency and soil transmitted helminth infections, we implemented a program to make WIFS and regular deworming treatment freely and universally available for all women of reproductive age in two districts of a province in northern Vietnam over a 12 month period. The impact of the program at the population level was assessed in terms of: i) change in mean hemoglobin and iron status indicators, and ii) change in the prevalence of anemia, iron deficiency and hookworm infections.

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“…Berger et al [ 205 ] tested a weekly combined iron-folic acid intervention in the preconception period among Vietnamese women and similarly found the supplementation significantly improved iron status and reduced anemia when compared to baseline. In the Philippines ferritin levels improved, however hemoglobin lagged behind, possibly due to women being deficient in other micronutrients related to heme formation which were not supplemented during the study [ 206 ]. The results of these interventions on a national level were similar to a previous randomized-controlled trial in Bangladesh [ 207 ] where iron-folic acid given as a powdered supplement added to food decreased anemia among non-pregnant women; however this benefit did not extend to those women who became pregnant.…”

Section: Nutritional Interventionsmentioning

confidence: 99%

Preconception care: nutritional risks and interventions

et al. 2014

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IntroductionThere is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy.MethodsA systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture.ResultsMaternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight.ConclusionAll women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition-sensitive strategies (such as food fortification; integration of nutrition initiatives with other maternal and child health interventions; and community based platforms) is necessary among adolescent girls and women of reproductive age. The effectiveness of interventions will need to be simultaneously monitored, and form the basis for the development of improved delivery strategies and new nutritional interventions.

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Government-Industry Partnership in Weekly Iron-Folic Acid Supplementation for Women of Reproductive Age in the Philippines: Impact on Iron Status

Cited by 15 publications

References 24 publications

Effect of Women's Nutrition before and during Early Pregnancy on Maternal and Infant Outcomes: A Systematic Review

Effect of Women's Nutrition before and during Early Pregnancy on Maternal and Infant Outcomes: A Systematic Review

A free weekly iron-folic acid supplementation and regular deworming program is associated with improved hemoglobin and iron status indicators in Vietnamese women

Preconception care: nutritional risks and interventions

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