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Oral ferrous sulfate supplementation taken daily in the early gestational phase (≤13 weeks and 6 days) may best meet the increased iron demands in the late third trimester for non-anemic women.
A novel study published in Blood Advances addressed the challenge of balancing oral iron doses with adherence and side effects in preventing iron deficiency anemia during pregnancy.
The study researchers conducted a pilot randomized trial to assess the effects of different oral iron supplementation schedules initiated early in pregnancy, focusing on four key areas: participant recruitment, adherence to the protocol, maintenance of maternal hemoglobin levels, and reporting of side effects.
In this study, 300 women were randomly assigned to one of three groups: daily administration of ferrous sulfate 200 mg, supplementation every other day, or thrice weekly. The follow-up continued until the delivery, with baseline characteristics well-matched across the groups. Overall, participants took an average of 82.5% of the prescribed tablets, with adherence rates of 47% for the daily group, compared to 62% for alternate-day dosing and 61% for the three-times-a-week schedule.
The reduction in hemoglobin levels between randomization and the 28-week mark was less pronounced in the daily dosing group. To add, while participants reported various side effects during antenatal visits, many symptoms overlapped with typical pregnancy experiences, confusing the attribution of discomfort to iron supplementation. To truly determine the clinical effectiveness of oral iron supplementation in preventing iron deficiency anemia, further randomized trials focusing on clinical outcomes are essential.
Blood Advances
The impact of different doses of oral iron supplementation during pregnancy: a pilot randomized trial
Simon J Stanworth et al.
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