Intermittent Versus Regular Daily Regimen of Antenatal Oral Iron Supplementation for Preventing Iron Deficiency Anemia During Pregnancy

Abstract

Background: Anaemia is a medical condition that is quite frequent during pregnancy and the postpartum period globally. It poses  several health hazards to both the mother and the child.

Objectives: This study aimed to evaluate the efficacy and adverse effects of intermittent versus regular daily regimen of antenatal oral  iron supplementation for preventing iron deficiency anemia (IDA) during pregnancy.

Patients and methods: A prospective randomized controlled study was conducted at Departments of Obstetrics and Gynecology,  Menoufia University Hospital and El Sahel Teaching Hospital through the period from February 2020 to December 2022. During this study,  two hundred sixteen non-anemic pregnant women were enrolled and divided into 3 equal groups (each group included 72  patients): Group A (daily) received 60 mg of elemental iron + 1000 ug folic acid daily, group B (every 3 days) received 60 mg of elemental  iron + 1000 ug folic acid twice weekly and group C (once weekly) received 120 mg of elemental iron + 2000 ug folic acid once weekly.  Complete blood picture and serum ferritin were done at the start of the study and compared with follow up levels at 28 and 36 weeks.

Result: Demographic data were matched between groups. hemoglobin, hematocrit and ferritin levels before and after iron  supplementation were comparable in the three groups regardless iron supplementation regimen. Iron side effects were more frequently  encountered in group A than in groups B and C (27.8% vs 15.3% and 9.7% respectively). Regression analysis revealed that regimen of iron  supplementation was not predictive of final hemoglobin concentration and the only significant predictor for final hemoglobin  concentration was the initial hemoglobin level.

Conclusion: Intermittent (once or twice weekly) iron supplementation is advisable to non- anemic pregnant women as it is not associated with increased risk for developing anemia or ID when compared to daily regimen with  fewer side effects.