title: Intermittent iron supplementation regimens are able to maintain safe maternal hemoglobin concentrations during pregnancy in Venezuela.
abstract: Daily iron supplementation programs for pregnant women recommend amounts of iron that are considered by some to be excessive, and either lower-dose or less frequent iron supplementation regimens have been proposed. A randomized, placebo-controlled study was performed to assess and compare the relative effectiveness of a weekly (WS) or twice weekly (TW) iron supplementation schedule in maintaining or achieving hemoglobin (Hb) levels at term considered to carry minimal maternal and fetal risk (90-130 g/L). Pregnant women (n = 116) at wk 10-30 of gestation (63 WS and 53 TW) were enrolled in the study (52 in WS and 44 TW completed the study). Women were randomly allocated to receive a 120-mg oral dose of iron as ferrous sulfate and 0.5 mg of folic acid weekly (n = 52) or 60 mg iron and 0.25 mg folic acid and a placebo twice weekly (n = 44). Hb, hematocrit, serum ferritin, and transferrin saturation were estimated at baseline and at 36-39 wk of gestation. Baseline dietary data and the presence and intensity of intestinal helminthic infections were assessed. The duration of supplementation was 14 +/- 4 wk and the median level of adherence was 60.5%. Hb concentrations improved in women following the TW regimen and in women following WS who had low baseline Hb levels. About 89% of WS women and 95% of TW women maintained Hb levels at term (between 90 g/L and 130 g/L), a range associated with optimal pregnancy outcomes. One woman in the TW group exhibited higher Hb levels that potentially carried perinatal risk (>130 g/L). Intermittent iron and folic acid supplementation may be a valid strategy when used as a preventive intervention in prenatal care settings.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Pena-Rosas
authors.forename: Malden C
authors.initials: MC
authors.lastname: Nesheim
authors.forename: Maria N
authors.initials: MN
authors.lastname: Garcia-Casal
authors.forename: D W T
authors.initials: DW
authors.lastname: Crompton
authors.forename: Diva
authors.initials: D
authors.lastname: Sanjur
authors.forename: Fernando E
authors.initials: FE
authors.lastname: Viteri
authors.forename: Edward A
authors.initials: EA
authors.lastname: Frongillo
authors.forename: Paulina
authors.initials: P
authors.lastname: Lorenzana
mesh_terms: D000284:Administration, Oral; D004032:Diet; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006373:Helminthiasis / Q000175:diagnosis / Q000503:physiopathology; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007422:Intestines / Q000469:parasitology*; D007501:Iron / Q000008:administration & dosage*; D009994:Osmolar Concentration; D010349:Patient Compliance; D011247:Pregnancy / Q000097:blood*; D012720:Severity of Illness Index; D014687:Venezuela
chemical_list: D006454:Hemoglobins; D005492:Folic Acid; D007501:Iron