Iron supplementation in pregnancy--does the preparation matter?
OBJECTIVE
To assess the use, side effects and discontinuation rates of iron preparations during pregnancy.


METHODS
Six hundred and twelve randomly selected postpartum women completed a questionnaire on iron supplement use in the second and third trimesters.


RESULTS
Of the 517 women (84.5%) reported using iron supplements, 453 were eligible for the study. The most common preparation was ferrous fumarate (46.8%, P < 0.01), followed by ferrous sulfate (31.8%), ferric polymaltose (12.4%), and ferric bisglycinate (7.3%). Almost half the participants (45%) reported at least one adverse effect, especially constipation (27.4%, P < 0.01), nausea (10.8%). Multivitamin preparations and ferric bisglycinate were associated with the fewest side effects (23.7, 21.2% respectively, P < 0.01), and ferrous fumarate and immediate-release ferrous sulfate with the most (56.3, 53.7% respectively). Eighty-three women discontinued their originally prescribed iron preparation, mainly (89%) due to side effects. Discontinuation rates were lowest for the multivitamin and ferric bisglycinate (10.5, 9.1%, respectively). In most cases, the specific preparation was recommended by the women's physician (76%).


CONCLUSIONS
Ferrous fumarate-containing multivitamin preparations and ferric bisglycinate, although infrequently recommended as the first-line of iron supplementation, may be associated with less side effects and better compliance.
Melamed
Nir
N
Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tiqwa, 49100, Israel.
Ben-Haroush
Avi
A
Kaplan
Boris
B
Yogev
Yariv
Y
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000009:adverse effects; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage / Q000009:adverse effects; D005296:Ferrous Compounds / Q000008:administration & dosage / Q000009:adverse effects; D006306:Health Surveys; D006397:Hematinics / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D010349:Patient Compliance; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011264:Pregnancy Trimesters
D005290:Ferric Compounds; D005296:Ferrous Compounds; D006397:Hematinics