Iron supplementation during pregnancy: what are the risks and benefits of current practices?

2007 ◽  
Vol 32 (2) ◽  
pp. 282-288 ◽  
Author(s):  
France M. Rioux ◽  
Caroline P. LeBlanc

Iron-deficiency anemia is still prevalent among pregnant women living in industrialized countries such as Canada. To prevent this deficiency, iron supplements (30 mg/d) are routinely prescribed to Canadian pregnant women. Recently, dietary reference intakes for iron have increased from 18 and 23 mg/d during the second and third trimesters, respectively, to 27 mg/d throughout the pregnancy for all age groups. Whether this new recommendation implies an increase of iron dosage in supplements has not been answered. Are there any benefits or risks for the mother and her infant associated with iron supplementation during pregnancy? If iron supplementation is recommended, what should be the ideal dosage? This article reviews current knowledge on the potential negative or positive impact of iron supplementation during pregnancy on the outcomes of both infants and mothers. Based on the literature reviewed, a low daily dose of iron (30 mg elemental iron) during pregnancy improves women’s iron status and seems to protect their infants from iron-deficiency anemia. Several studies have also shown that a low daily dose of iron may improve birth weight even in non-anemic pregnant women. However, higher dosages are not recommended because of the potential negative effects on mineral absorption, oxidative pathways, and adverse gastrointestinal symptoms. To date, it is still not clear if health professionals should recommend routine or selective supplementation. However, neither routine nor selective iron supplementation during pregnancy is able to eliminate iron-deficiency anemia. Even though the dietary reference intake for iron during pregnancy has been recently increased, we do not recommend higher doses of iron in supplements designed for pregnant women.

2020 ◽  
Vol 51 (4) ◽  
pp. 212-219
Author(s):  
Sylwia Sulimiera Michalak

AbstractIron deficiency anemia (IDA) treatment is done to eliminate the causes of iron deficiency, iron supplementation, and rarely red blood cell transfusion. Divalent iron salts are the first line of oral treatment, but their use lead to frequent gastrointestinal adverse reactions. Iron is administered intravenously in the event of contraindications, intolerance, or inefficiency of oral therapy, but the parenteral route of drug delivery is not easily accepted by the patients. Intravenous preparations for single administration of a large dose of iron have a good therapy safety profile, but are more expensive than oral and are usually administered in a hospital setting. The availability of new iron compounds: sucrosomial iron, ferric citrate complexes, and ferric maltol widen the possibilities of IDA therapy and enable the better selection of iron preparations in various clinical situations. The innovative structure of sucrosomial iron leads to absorption in different ways (through endocytosis, the paracellular pathway, M cells of Peyer's patches), ensures high bioavailability, and good tolerance of therapy. Ferric citrate, in addition to iron supplementation, reduces phosphate levels, and is beneficial to chronic kidney disease. Ferric maltol is currently being studied for IDA treatment with various comorbidities. Some studies indicate that new iron formulas may be used where intravenous intake has been recommended so far. So, we can expect treatment with iron nanoparticles and drugs that affect the intestinal microflora in the future. The paper presents current knowledge about new iron preparations that are already available in everyday practice, but also those that are at various stages of pre-clinical and clinical studies.


Author(s):  
Safa F. Omer ◽  
Suaad Elnour ◽  
GadAllah Modawe

Backgrounds: Iron supplementation is most widely used approach of controlling the global problem of iron deficiency anemia especially in pregnant anemic women. Anemia is one of the most frequent complications related to pregnancy. Normal physiological changes in pregnancy affect the hemoglobin (Hb), Epidemiological studies have shown high serum iron concentrations following abnormal levels of blood lipids are risk factors for coronary artery disease and myocardial infarction. Both iron deficiency anemia and dyslipidaemia are widely prevalent public health problems, especially in the Sudanese pregnant women. Objectives: The aim of present study was to measure the serum level of lipids profile in anemic pregnant women compared to non anemic pregnant women. Methodology and Study Population: The analytical case control study conducted in obstetrics and gynecology centre, Omdurman city, Khartoum state. One hundred subjects known with 50 pregnant anemic as case groups and 50 non anemic pregnant  women as control groups were enrolled in this study, with  match age and sex,  the age ranged between (20 to 40 years) and their mean (31.7±4.34). The serum lipid profile was analyzed using spectrophotometric method. Results: The (mean±SD) of Hb, HDL, LDL, TG and TC in anemic pregnant women respectively were (68.15±9.35, 46.06±9.62, 114.14±36.86, 170.38±54.57. 197.16±46.83). While the (mean±SD) of Hb, HDL, LDL, TG and TC in non anemic pregnant women respectively were (79.76±7.22, 47.44±9.65, 140.00±40.76, 189.72±37.89, 224.38±45.09). The concentration of Hb was highly significantly decrease in anemic pregnant compare to non anemic pregnant women with p value (p=0.000). The level serum of LDL, TG and TC were significantly decrease in anemic pregnant compare to non anemic pregnant women with p value (p= 0.001, 0.042, 0.004) respectively.  The age of study population were no correlation with serum LDL(r= -0.155, p= 0.283), HDL(r= -0.019, p=0.898) and TC (r=0.68, p=0.640). And also their positive correlation between age and serum TG (r= 0.286, P=0.044). Conclusion: The anemic pregnant women had a significantly decreased of Hb and serum LDL, TG and TC and also their positive correlation between age and serum TG.


2012 ◽  
Vol 19 (02) ◽  
pp. 155-158
Author(s):  
SAEED SIDDIQUI ◽  
ATIF SITWAT HAYAT ◽  
M. KHALID SIDDIQUI ◽  
Naila Atif ◽  
Hamayun Shah

Objectives: To estimate the frequency of iron deficiency anemia in a sample of population of pregnant women residingpermanently at high altitude of ≥5000 feet in different areas of district Abbottabad. Study Design: Cross sectional Study. Place & duration ofStudy: Northern Institute of Medical Sciences Abbottabad: From 17 August 2009 to 15 June 2010. Subjects and Methods: This study wascarried out on hundred pregnant women residing permanently at an altitude of ≥5000 feet above sea level in district Abbottabad. The agerange was fixed to 15-45 (child bearing age ) years. Suspected study participants having anemia were tested for iron status by serum ferritintest. Pregnant women having both anemia and iron deficiency were labeled as patients of Iron deficiency anemia. Results: The age range was15-41 years with a mean of + / - SD of 28.13 + / - 6.61. All women were of low and middle socioeconomic class with 74 % illiteracy. 60 % of womenhad birth spacing of two or less than two years. 64 % of pregnant women had three children. Anemia was detected in 74 % (X2 =9.42 p > 0.05),iron deficiency in 66 % (X2 = 14.76 p <0.01) and iron deficiency anemia in 60 % (X2 = 13.56 p < 0.01). Conclusions: High altitude residentpregnant women remain at high risk of developing iron deficiency anemia because of illiteracy, poverty and ignorance. With adequate nutritionand health education the problem can be addressed effectively.


2019 ◽  
Vol 14 (1) ◽  
pp. 1-6
Author(s):  
Tahmina Akter ◽  
Qazi Shamima Akhter

Background: Common clinical practice of prescribing Iron supplementation for Iron deficiency anemia (IDA) in pregnancy is associated with a number of side effects. Emblica officinalis (amloki) is a well known dietary supplement used by traditional practitioners to treat anemia. Objective: To evaluate the effects of oral supplementation of Emblica officinalis on iron status in pregnant women with IDA. Methods: This prospective interventional study was carried out in the Department of Physiology, Dhaka Medical College (DMC), Dhaka from July 2016 to June 2017 on 43 pregnant women aged 18 to 36 years between 13th to 20th weeks of gestation with IDA. They were recruited from the Out-patient department of Obstetrics and Gynaecology, DMC Hospital. Among them 24 were supplemented with amloki and iron (IAS) and 19 women received only iron supplementation (IS). Study variables were estimated at the baseline and after 45 days of supplementation. Serum iron, ferritin and Total iron binding capacity (TIBC) were estimated following standard laboratory methods. Data were expressed as mean ± SD. Paired and Unpaired Student’s t-test were used for statistical analysis. Results: Serum iron levels were significantly higher (p<0.001) and serum TIBC were significantly lower (p<0.001) in both groups after supplementation compared to their baseline value. But post supplementation serum ferritin level was significantly higher (p<0.01) only in IAS group compared to that of the baseline. Again, after intervention, serum iron level was significantly higher (p<0.05) and serum TIBC was significantly lower (p<0.01) in IAS group when compared with those of IS group. Conclusions: Data concluded that oral Emblica officinalis supplement along with iron was more effective than only iron supplementation to improve serum iron status in pregnant women with IDA. J Bangladesh Soc Physiol. 2019, June; 14(1): 1-6


2021 ◽  
Vol 53 (2) ◽  
Author(s):  
Donel Donel ◽  
Dhini Aiyulie Novri ◽  
Ruza Prima Rustam ◽  
Maya Savira

In pregnant women there is a twofold increase in iron requirements due to increased blood volume without the expansion of plasma volume. Pregnant women are very prone to suffering from iron deficiency anemia. Iron deficiency anemia generally has an erythrocyte index which represents hypochromic microcytic. This study aimed to determine the effect of three-month iron tablet supplementation as a therapy against microcytic hypochromic anemia in pregnancy. This was a quantitative quasi-experimental study using pre-test and post-test design. The study was conducted in May-September 2020 at the Arifin Achmad Regional General Hospital, Riau Province, Indonesia. Subjects were 30 pregnant women with microcytic hypochromic anemia. Primary data were analyzed using statistical paired sample t-tests. Results showed that there was an increase in hemoglobin levels after the supplementation of iron tablet from an average of 9.1 ± 1.2 gr/dl to 11.8 ± 1.0 g/dl. This change was significant based on the results of the T-test (p-0.003) Thus, iron supplementation for three month significantly increases hemoglobin levels in pregnant women.


2019 ◽  
Vol 10 (2) ◽  
pp. 91-100
Author(s):  
Putri Bungsu Machmud ◽  
Ratna Djuwita Hatma ◽  
Ahmad Syafiq

Background. Anemia in pregnancy is an essential problem due to affect to not only the mother’s life but also to baby’s life. An iron deficiency causes about 75 percent of anemia during pregnancy. Objective. This study aimed to identify risk factors for iron deficiency among pregnant women and determine the possible link between iron status and tannin levels associated with tea consumption. Method. The population-based cross-sectional studies were conducted from secondary data of previous thesis-research in 2013, “Pengaruh Kadar Tanin pada Teh Celup terhadap Anemia Gizi Besi (AGB) pada Ibu Hamil di UPT Puskesmas Citeureup Kabupaten Bogor Tahun 2012”. The study population consisted of 94 randomly selected pregnant women. The inclusion criteria were pregnant women who participated in the previous study and have a complete antenatal care record. Demographic data were collected, including data on age, working status, gestational stage, time since last pregnancy, and parity. The information included nutritional variables, such as iron supplements, nutritional status, and iron intake. Also, data for tannin level grouped as low, medium, and high based on the frequency of daily tea consumption and tea-making habits. The linear model analysis was used to determine the influence of tea consumption on serum ferritin levels. Results. The results showed that time since last pregnancy (<2 years), parity (more than two children), reduced consumption of foods containing heme, and levels of tannin consumption (low, medium, or high) were predictors of iron-deficiency anemia. The results also suggested that tannin levels were inversely proportional to serum ferritin levels. Conclusion. Pregnant women who consumed tea with a low tannin level had the highest serum ferritin levels, whereas those who drank tea with medium and high tannin levels had the lowest serum ferritin levels.


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