Topic Summary
According to Angulo-Barroso et al. (2016), the World Health Organization (WHO) recommends that pregnant women receive 30mg to 60mg of elemental in combination with 0.4mg of folic acid in order protect them from maternal anemia and puerperal sepsis as well as ensure that low birth weights and preterm births are prevented. Sixty milligrams of elemental iron is equivalent to 500 mg ferrous gluconate, 300 mg ferrous sulfate heptahydrate or180 mg ferrous fumarate or 500 mg ferrous gluconate. In order to prevent neural tube defects to the fetus, WHO recommends that folic acid is started early enough preferably before conception. The reason for conducting research on this topic is to assess the effects of daily oral iron supplementation to expectant mothers in combination with folic acid.
Summary of the Article
Background: For some time now, iron and folic acid supplements have been used as an intervention in improving iron stores and therefore anemia prevention among expectant mothers. This supplementation is also thought to be important in ensuring the improvement of other birth and maternal outcomes.
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Objectives: To carry out the assessment of the effects of daily oral iron and folic supplements on expectant mothers.
Search methods: The authors of the article searched Childbirth Group's Trials Register and Cochrane Pregnancy. Additionally, they contacted relevant organizations in order to identify the unpublished and ongoing studies and searched the WHO International Clinical Trials Registry Platform.
Selection Criteria: Quasi-randomized or randomized trials that evaluate the effects of daily oral iron supplements, iron with folic supplements, or iron with other vitamins/minerals in pregnancy.
Data collection and analysis: Standard Cochrane criteria were utilized to assess the methodological quality of the trials. Accuracy checks, trial eligibility, and extracted data were independently assessed by two review authors. The evidence quality for the primary outcomes was assessed using the GRADE approach. High heterogeneity was anticipated among various trials and trial results were pooled by use of the random effect model. The authors exercised high caution when interpreting the pooled outcomes which gives the mean treatment impact.
Results: Sixty-one trials were included where data was obtained from 44 trials (
Involved 43274 women) and the effect of daily oral supplements with iron versus without iron or placebo. Daily oral iron supplement reduced maternal anemia at birth by 70 percent and had a confidence interval of 95 percent. In the second and third trimester, there were no major differences observed between groups of women for severe anemia or maternal gestational infection. Women who received daily iron supplement had a higher probability of having higher hemoglobin (Hb) concentration at delivery as well as after delivery. However, they were more likely to have Hb concentration of more than 13g/dl during gestation and at delivery. Women who had iron supplements less frequently gave birth to low birth weight newborns. However, there were no significant differences between groups as far as neonatal death is concerned.
Conclusion: Daily oral iron decreases the risk of iron deficiency anemia/maternal anemia during pregnancy but shows less clarity in other positive impacts in infant and maternal outcomes. If iron supplementation recommendations are to be implemented, it may give heterogeneous outcomes based on the population’s background risk for anemia, low birth weight, and intervention adherence.
Own Conclusion
The topic represented good science because I was able to learn the role of iron and folic supplements in the prevention of maternal/iron deficiency anemia in pregnant women and neural tubes defects to the developing baby/newborns respectively (Peña‐Rosas et al., 2015). One thing I came to believe as a result of the information provided in this research is that daily oral iron and folic supplements are essential for pregnant women as recommended by the World Health Organization.
References
Angulo-Barroso, R. M., Li, M., Santos, D. C., Bian, Y., Sturza, J., Jiang, Y., ... & Lozoff, B. (2016). Iron supplementation in pregnancy or infancy and motor development: a randomized controlled trial. Pediatrics, 137(4).
Peña‐Rosas, J. P., De‐Regil, L. M., Garcia‐Casal, M. N., & Dowswell, T. (2015). Daily oral iron supplementation during pregnancy. Cochrane database of systematic reviews, (7).
