Intermittent oral iron supplementation during pregnancy.

RATIONALE: It has been suggested that in pregnant women weekly iron supplements are as effective as daily supplements in preventing iron deficiency anaemia (IDA). OBJECTIVE: To compare the effectiveness of prophylactic antenatal oral iron supplements given weekly, thrice weekly and daily in preventing IDA in pregnancy. DESIGN: A randomised control trial. SETTING: University antenatal clinic, (UANC) Galle. SUBJECTS AND METHOD: An oral iron supplement containing 100 mg of elemental iron was randomly given weekly (n = 26) thrice weekly (n = 35) and daily (n = 31) to 92 women who were 14 to 24 weeks pregnant. Haemoglobin (Hb), serum ferritin (SF) and haematocrit (Hct) were assessed before and after 12 to 20 weeks of supplementation and a logistic regression analysis carried out. RESULTS: The risk of developing anaemia was significantly higher in the weekly (odds ratio 15, 95% CI 1.4-165.6, p < 0.03) and possibly higher in the thrice weekly (odds ratio 3, 95% CI 0.3-30.3, p = 0.3) groups. The risk of developing iron deficiency (SF < 12 micrograms/l) was also significantly higher in the weekly (odds ratio 18, 95% CI 2.8-115.5, p < 0.003) and thrice weekly (odds ratio 10, 95% CI 1.6-64.8, p < 0.02) groups. CONCLUSION: Prophylactic oral iron supplements when given intermittently were not effective in preventing iron deficiency anaemia in pregnancy.

Iron stores and its correlation to haemoglobin levels in pregnant women attending an antenatal clinic.

OBJECTIVES: To determine the rate of iron deficiency in women coming for antenatal care and to asses whether the haemoglobin concentration is a good index in its detection. DESIGN: A cross sectional cohort study. SETTING: University antenatal clinic, Teaching Hospital, Galle. SUBJECTS: Haemoglobin (Hb), haematocrit (HC) and serum ferritin (SF) were estimated in 236 women. RESULTS: Only 7(3%) women had satisfactory iron stores as shown by SF of over 60 ng/ml. SF levels of less than 10 ng/ml indicating complete depletion of iron stores were found in 135(57%). An Hb level of 11 g/dl, which is the recommended cut off point for the diagnosis of anaemia, had a sensitivity of 63% and a negative predictive value of 41% in the detection of iron deficiency in the study population. The SF was poorly correlated to the Hb at Hb levels of more than 11 g/dl. (r2 = 0.000342, P > 0.5). CONCLUSION: In women attending for antenatal care the rate of iron deficiency is high (69%). The haemoglobin concentration is not a good index to detect this.