Haemoglobin Levels in Pregnancy

Wills, Lucy; Hill, Gladys; Bingham, Kaitilin; Miall, Margaret; Wrigley, J. H.

doi:10.1079/bjn19470024

Cited by 19 publications

(11 citation statements)

References 11 publications

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“…The studies included in the review were carried out since 1936 in countries across the globe: 25 trials in Europe with 12 trials in United Kingdom (Butler 1968; Chanarin 1965; Chisholm 1966; Chanarin 1971Fenton 1977; Foulkes 1982; Harvey 2007; Kerr 1958; Paintin 1966; Taylor 1982 Willoughby 1967; Wills 1947); two trials in Norway (Eskeland 1997; Romslo 1983); two trials in Finland (Hemminki 1991; Puolakka 1980), two trials in Sweden (Svanberg 1975; Tholin 1993), two trials in the Netherlands. (Van Eijk 1978; Wallenburg 1983); one each in Denmark (Milman 1991); Ireland (Barton 1994); Belgium (Buytaert 1983); France (De Benaze 1989) and Italy (Tura 1989).…”

Section: Resultsmentioning

confidence: 99%

“…The daily dose of elemental iron in some of the groups in the included trials ranged between 9-90 mg of elemental iron daily. One trial provided 9 mg elemental iron daily (Eskeland 1997); one trial provided 12 mg elemental iron (Paintin 1966); one trial provided 20 mg elemental iron daily (Makrides 2003); one trial provided 27 mg elemental iron (Eskeland 1997); six trials provided 30 mg elemental iron (Chanarin 1971; Cogswell 2003; Lee 2005; Ouladsahebmadarek 2011; Siega-Riz 2001; Zeng 2008 (C); one trial provided 40 mg elemental iron (Tura 1989); 45 mg elemental iron (De Benaze 1989); 50 mg elemental iron (Ziaei 2007, Ziaei 2008); 55 mg elemental iron (Hood 1960); 17 trials provided 60 mg elemental iron (Barton 1994; Batu 1976; Chan 2009; Christian 2003 (C); Falahi 2010; Fenton 1977; Fleming 1974; Fleming 1985; Groner 1986; Han 2011; Hoa 2005 (C); Ma 2010; Meier 2003; Menendez 1994 (C); Suharno 1993; Sun 2010; Zeng 2008 (C)); two trials provided 65 mg of elemental iron (Kuizon 1979; Taylor 1982); 66 mg elemental iron (Milman 1991); two trials provided 78 mg elemental iron (Cantlie 1971; Freire 1989); one trial provided 80 mg elemental iron (Wills 1947); nine trials provided 100 mg of elemental iron (Foulkes 1982; Hankin 1963; Harvey 2007; Hemminki 1991; Liu 2000; Preziosi 1997; Simmons 1993; Tholin 1993; Van Eijk 1978); five trials provided 105 mg of elemental iron daily (Buytaert 1983; Kerr 1958; Paintin 1966; Wallenburg 1983; Willoughby 1967); one trial provided 112 mg elemental iron (Pritchard 1958); two trials provided 120 mg of elemental iron (Charoenlarp 1988; Dommisse 1983); one trial provided 122 mg of elemental iron (Butler 1968); three trials provided 200 mg of elemental iron (Puolakka 1980; Romslo 1983; Svanberg 1975); 220 mg elemental iron (Hood 1960); 240 mg of elemental iron (Charoenlarp 1988) and ...…”

Section: Resultsmentioning

confidence: 99%

“…Ferrous gluconate was used in six included trials (Chisholm 1966; Hankin 1963; Harvey 2007; Kerr 1958; Pritchard 1958; Wills 1947). Two trials used ferrous betainate hydrochloride (De Benaze 1989; Preziosi 1997), one trial used heme iron from porcine blood (Eskeland 1997), one trial used ferritin in a micro granulated gastric resistant capsule (Tura 1989), one used chelated iron aminoates (Willoughby 1967) and one study (Han 2011) used iron EDTA.…”

Section: Resultsmentioning

confidence: 99%

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Daily oral iron supplementation during pregnancy

Peña-Rosas

De-Regil

Dowswell

et al. 2012

Cochrane Database of Systematic Reviews

400

373

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Daily oral iron supplementation during pregnancy

Peña-Rosas

De-Regil

Dowswell

et al. 2012

Cochrane Database of Systematic Reviews

400

373

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“…Women were randomly allocated to one of five interventions: group 1 received no prophylactic supplements; group 2 received 105 mg of elemental iron daily (as chelated iron aminoates); group 3 received 105 mg of elemental iron with 100 μ g (0.1 mg) folic acid; group 4 received 105 mg of elemental iron daily with 300 μ g (0.3 mg) folic acid; and group 5 received 105 mg elemental iron daily with 450 μ g (0.45 mg) folic acid. Starting and ending time of supplementation variable Willoughby 1968 68 pregnant women attending antenatal care clinic in Queen Mother’s Hospital in Scotland, were randomly allocated to receive 195 mg of elemental iron alone daily or 195 mg of elemental iron in conjunction with 300 μ g (0.3 mg) folic acid daily Wills 1947 500 pregnant women attending antenatal care clinic at the Royal Free Hospital in London, England, United Kingdom during wartime, with ages between 18-43 years. Women with severe anaemic or rheumatoid arthritis were excluded.…”

Section: Discussionmentioning

confidence: 99%

Intermittent oral iron supplementation during pregnancy

Peña-Rosas

De-Regil

Dowswell

et al. 2012

Cochrane Database of Systematic Reviews

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Background Anaemia is a frequent condition during pregnancy, particularly among women from developing countries who have insufficient iron intake to meet increased iron needs of both the mother and the fetus. Traditionally, gestational anaemia has been prevented with the provision of daily iron supplements throughout pregnancy, but adherence to this regimen due to side effects, interrupted supply of the supplements, and concerns about safety among women with an adequate iron intake, have limited the use of this intervention. Intermittent (i.e. one, two or three times a week on non-consecutive days) supplementation with iron alone or in combination with folic acid or other vitamins and minerals has recently been proposed as an alternative to daily supplementation. Objectives To assess the benefits and harms of intermittent supplementation with iron alone or in combination with folic acid or other vitamins and minerals to pregnant women on neonatal and pregnancy outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (23 March 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) for ongoing studies and contacted relevant organisations for the identification of ongoing and unpublished studies (23 March 2012). Selection criteria Randomised or quasi-randomised trials. Data collection and analysis We assessed the methodological quality of trials using standard Cochrane criteria. Two review authors independently assessed trial eligibility, extracted data and conducted checks for accuracy. Main results This review includes 21 trials from 13 different countries, but only 18 trials (with 4072 women) reported on our outcomes of interest and contributed data to the review. All of these studies compared daily versus intermittent iron supplementation. Three studies provided iron alone, 12 iron+folic acid and three more iron plus multiple vitamins and minerals. Their methodological quality was mixed and most had high levels of attrition. Overall, there was no clear evidence of differences between groups for infant primary outcomes: low birthweight (average risk ratio (RR) 0.96; 95% confidence interval (CI) 0.61 to 1.52, seven studies), infant birthweight (mean difference MD −8.62 g; 95% CI −52.76 g to 35.52 g, eight studies), premature birth (average RR 1.82; 95% CI 0.75 to 4.40, four studies). 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, four studies) and women receiving intermittent supplementation had less side effects (average RR 0.56; 95% CI 0.37 to 0.84, 11 studies) than those receiving daily supplements. Women receiving intermittent supplements were also at lower risk of having high haemoglobin (Hb) concentrations (greater than 130 g/L) during the second or third trimester of pregnancy (average RR 0.48; 95% CI 0.35 to 0.67, 13 studies). There were no significant differenc...

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“…The Report on Confidential Enquiries into Maternal Deaths in England andWales (1952-1954) stated that it is well known that preexisting anaemia is an important factor in many cases of haemorrhage. In similar vein Wills et al (1947) reported a greater incidence of postpartum haemorrhage in women who took no additional iron during pregnancy.…”

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confidence: 73%

Antenatal Anaemia and Postpartum Haemorrhage

Dewar

1969

Aust NZ J Obst Gynaeco

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Summary and Conclusion A study was made of the postpartum haemorrhage rates in 170 patients with iron‐deficiency anaemia diagnosed in the last 3 weeks of pregnancy and in 1,743 non‐anaemic patients, both groups being delivered at National Women's Hospital during the period January to August, 1966. No significant difference between the 2 groups was found. It was concluded that urgent methods (blood transfusion and intravenous iron therapy) of overcoming iron‐deficiency anaemia in the last 3 weeks of pregnancy are not justifiable quite apart from their risks.

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Haemoglobin Levels in Pregnancy

Cited by 19 publications

References 11 publications

Daily oral iron supplementation during pregnancy

Daily oral iron supplementation during pregnancy

Intermittent oral iron supplementation during pregnancy

Antenatal Anaemia and Postpartum Haemorrhage

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