Research: ESKELAND and colleagues,

Listed in Issue 30

Abstract

ESKELAND and colleagues, Department of Public Health and Primary Health Care, University of Bergen Norway conducted a study to evaluate the efficacy of low-dose supplementation of iron with and without a haeme component, prescribed for women in the second half of their pregnancy.

Background

Methodology

90 women participated in a randomised, double-blind placebo controlled trial and were randomised into 3 groups: 1) 31 women received a daily dose of 27 mg elemental iron supplement (Hemofer) containing both haeme and non-haeme 2) 30 women received the same dose as pure non-haeme iron with vitamin C (Collets) and 29 women received placebo. The tablets were masked using a double dummy technique. The women were tested for red cell indices and the iron status markers s-ferritin, s-iron, Total Iron Binding Capacity and red blood cell protoporphyrin through their pregnancy and 8 and 24 weeks after giving birth. Results were analysed according to “intention to treat” principle>

Results

The haematological results were equal in the 2 treatment groups. 52% of the women fell below 110 g/l in Haemoglobin (Hb), with only 25% of the women in the supplemented women. No women in the supplemented groups fell below 100 g/l, compared to 14% in the placebo group. Iron status were significantly better for all parameters in the haeme iron group compared to placebo by the end of pregnancy. Within the haeme iron group, there were fewer women with empty iron stores postpartum than at the start of pregnancy (from 14% to 8%). In the non-haeme iron group there was a significant increase from 3% to 27% and in the placebo group the percentage of women with empty iron stores more than doubled, from 21% to 52%.

Conclusion

A daily dose of 27 mg elemental iron with haeme given in the second half of pregnancy prevents depletion of iron stores following birth for most women.

References

Eskeland B et al. Iron supplementation in pregnancy: is less enough? A randomized, placebo controlled trial of low dose iron supplementation with and without heme iron. Acta Obstet Gynecol Scand 76 (9): 822-8. Oct 1997.

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