Iron status in Nigerian mothers and their newborns.

An evaluation of iron status was carried out on 364 Nigerian pregnant women from Niamey at delivery and in cord blood from their newborns. Anemia, defined as a low hematocrit value, was observed in 46% of pregnant women. Iron deficiency, recognized by a combination of, at least, 2 abnormal values in the 3 independent indicators measured (serum ferritin level, erythrocyte protoporphyrin concentration and transferrin saturation) was present in 47.8% of pregnant women. Anemia was associated with iron deficiency in 60.1% of cases in anemic mothers. A correlation between maternal and newborn iron indicators was found. This study points out the necessity for developing strategies in Sahelian countries to combat iron deficiency during pregnancy by specific measures in combination with more general interventions.     

铁剂对缺铁孕妇和新生儿干预作用的研究

目的 :　研究孕妇缺铁导致新生儿缺铁的发病情况和补充铁剂的干预作用。方法 :　 44例孕妇分为对照组和铁剂组 ,孕中期开始分别服用安慰剂或铁剂。分别测定孕妇在服药前、服药后及新生儿的各项铁指标 :血清铁 (serum iron,SI)、总铁结合力 (total iron binding capacity,TIBC) ,转铁蛋白饱和度 (transferrin saturation,TS) ;血清铁蛋白 (serum ferritin,SF)。血红蛋白(Hb)值为临床资料。结果 :　对照组新生儿 Hb、SI、TS、SF平均值均低于铁剂组新生儿 ;对照组新生儿贫血发病率和贮铁不足率达 80 %、54.5% ,明显高于铁剂组。除母血 SF与新生儿 SI以外 ,孕妇与新生儿的 SI、TS、SF之间呈不同程度的显著正相关。孕末期铁剂组孕妇缺铁性贫血人数明显少于对照组 ;对照组孕妇孕末期 Hb、SI、TS、SF较孕中期进一步降低或维持原来的低水平 ,而铁剂组孕妇孕末期 Hb、SI、TS较孕中期有增加 ,SF未进一步降低。结论 :　孕妇与新生儿的铁营养状况密切相关 ,孕妇缺铁会导致新生儿缺铁。补充铁剂能减少孕妇及其新生儿缺铁     

孕母铁缺乏对新生儿铁水平的影响

目的:通过对孕母及新生儿铁相关指标的追踪调查探讨孕母铁缺乏对新生儿铁水平的影响。方法:全程追踪81例孕母,分别于孕早、中、晚期及分娩时测定血液中血红蛋白(Hb)、网织红细胞(Ret)、网织红细胞成熟指数(RMI)、血清铁(SI)、血清铁蛋白(SF)和血清转铁蛋白受体(sTfR)。结果:孕母孕早期各组间SF和SI的差异有统计学意义(P<0.05,P<0.01)。孕中期及孕晚期各组间SF的差异有统计学意义(P<0.05,P<0.01)。全程缺铁性贫血(IDA)组、中晚孕期IDA组与全程正常组组间比较及孕中晚期不同铁水平组间比较SI及SF的差异均有统计学意义(P<0.01,P<0.05)。结论:孕母不同孕期、不同程度铁缺乏对新生儿脐血铁水平有影响,孕母轻度铁缺乏会影响新生儿铁贮备,孕母缺铁越早对新生儿铁贮备的影响越大。     

Modifications of hemato-biological parameters in pregnant women in a migrating population in northern Cameroon: prevalence of anemia, iron and folates deficiencies

The wholesale displacement of a population can have nutritional consequences for the migrants. With this in mind, the prevalences of anemia and of iron and folic acid deficiencies were studied in a group of 90 pregnant women living in northeast Benoue, an area situated in northern Cameroon where a development project was initiated in 1973. This project aimed at moving a population from the extreme northern highlands to the fertile valley of the Benoue. The following hemato-biological parameters were measured: hemoglobin, hematocrit, mean cell hemoglobin concentration, plasma iron, transferrin saturation, serum concentrations of folates, prealbumin, transferrin, protides and their fractions. The investigation showed that anemia, as well as iron and folic acid deficiencies, were rare when using World Health Organization criteria. The anemia prevalence, judged on a hemoglobin level of less than 11 g per 100 ml, is 8%, iron deficiency prevalence is 10% (plasma iron level below 50 micrograms per 100 ml), and folic acid deficiency prevalence is 3% (serum folic acid level below 3 ng per ml). However, 40% of the pregnant women had a level of transferrin saturation below 15%. In non deficient subjects, we observed a decrease between the first and second trimesters of pregnancy in hemato-biological parameters linked to anemia or to nutritional status (hemoglobin, hematocrit, plasma iron, transferrin saturation, prealbumin). The nutritional conditions in the area appeared sufficient to prevent deficiencies which are frequently observed in pregnant women in Africa.     

Iron status and its association with pregnancy outcome in Korean pregnant women

OBJECTIVE: The purpose of this study was to assess the prevalence of iron deficiency anemia among Korean pregnant women and to assess the association between maternal hemoglobin (Hb) level and pregnancy outcome. DESIGN: A longitudinal study. SETTING: Ewha Womans University Hospital, Seoul, Korea. SUBJECTS: A total of 248 normal pregnant women of 24-28 weeks gestation and 190 babies born to the pregnant subjects. METHODS: Maternal anthropometry, blood parameters and pregnancy outcomes were measured. RESULTS: Mean Hb, serum iron concentration, transferrin saturation and total iron binding capacity of the subjects were 11.4 g/dl, 89.4 microg/dl, 18.7% and 484.6 microg/dl, respectively, and 30.2% of the subjects were anemic judged by Hb concentration of <10.5 g/dl. When subjects were classified into tertile groups based on Hb levels, the lowest tertile (HbT1) group had significantly lower concentrations of cord serum iron and albumin than those in the highest tertile (HbT3) group. Newborn infants from the HbT1 group had significantly higher rates of preterm delivery, low birth weight and low Apgar scores than those in other groups. Logistic regression analysis showed that maternal serum albumin and Hb level were the most important predictive variables for low birth weight.Conclusions:A substantial proportion of Korean pregnant women were at risk of anemia. Infants born to women with a low Hb level showed a lower birth weight, height and Apgar scores.     

Iron status in Ecuadorian pregnant women living at 2,800 m altitude: relationship with infant iron status

An evaluation of iron status was performed in 84 pregnant women at delivery (and in cord blood from their newborn) and in a control group of 32 menstruating women living in Quito (2800 m altitude). Anemia as defined according to the WHO references adjusted to altitude was observed in 46% of pregnant women. Iron deficiency was defined as the combination of a low serum ferritin level (12 micrograms/l or less) and a low transferrin saturation percentage (less than 16%). A moderate elevation in the serum ferritin concentration (between 13 and 50 micrograms/l) associated with low transferrin saturation indicated iron deficiency in an inflammatory context. Iron deficiency was present in 46% of pregnant women. Anemia was associated with iron deficiency in 59% of cases. A correlation between maternal and cord blood hemoglobin was found and some iron parameters in cord blood were related to maternal iron status, and especially to maternal iron stores assessed by serum ferritin concentration.     

Cross-sectional study on the iron and vitamin A status of pregnant women in West Java, Indonesia.

A cross-sectional study of the prevalence of iron and vitamin A deficiency in normal pregnant women in West Java, Indonesia, was carried out. Of the 318 women studied, 49.4% were anemic and, according to multiple criteria, 43.5% had iron-deficiency anemia, 22.3% had iron-deficient erythropoiesis, and 6.6% had iron depletion. Serum retinol values revealed that 2.5% of the pregnant women were vitamin A deficient and 31% had marginal vitamin A status. The relative dose-response test carried out on 45 women showed that 4 (8.9%) had deficient vitamin A liver stores. After gestational stage, parity, and subdistrict were adjusted for, serum retinol concentrations were significantly positively associated (P < 0.01) with hemoglobin concentrations, hematocrit, and serum iron concentrations. The suboptimal vitamin A status associated with nutritional-deficiency anemia suggests that pregnant women in the area should be supplemented not only with iron but also with vitamin A. This proposal should be tested in an intervention study.     

Anemia at delivery in Lome (Togo): prevalence, risk factors and consequences in newborn infants]

A prevalence study was carried out on 125 mothers and their newborns in Lome (Togo): at delivery 48% of the mothers and 30% of the newborns were anaemic according to WHO criteria. Iron deficiency was the major determinant of anaemia in the mothers, as three out of four showed at least one biochemical indicator of iron deficiency. Folate deficiency was detected in 68% of the mothers but did not influence their haematological parameters. Severe iron deficiency in the mothers (serum iron < 7 mumol/l) was associated with a decrease in serum iron in the newborns, thus demonstrating an impaired iron transfer to the fetus. Folate supplementation of the mothers during pregnancy improved their newborn's folate status. A systematic ferro-folic supplementation is needed during pregnancy and would be beneficial to both mothers and newborns. Supplements could be given to women at prenatal care clinics. Attendance in these centers by 98% of pregnant women in Lomé allows us to anticipate a good coverage for such an intervention.     

Micronutrient deficiencies in early pregnancy are common, concurrent, and vary by season among rural Nepali pregnant women

Pregnant women in developing countries are vulnerable to multiple micronutrient deficiencies. We investigated their prevalence and seasonal variation as part of a baseline assessment in a population-based, maternal micronutrient supplementation trial conducted in the rural Southeastern plains of Nepal. Serum concentrations of 11 micronutrients were assessed in 1165 pregnant women in the 1st trimester before supplementation. Using defined cutoff values, the prevalence of deficiencies of vitamins A, E, and D were 7, 25, and 14%, respectively. Nearly 33% of the women were deficient in riboflavin, and 40 and 28% had serum vitamin B-6 and B-12 deficiencies, respectively. Only 12% of the women were folate deficient, but 61% were zinc deficient. The prevalence of low serum iron concentration was 40%, and 33% were anemic (hemoglobin < 110 g/L). Multiple micronutrient deficiencies were common among pregnant women. Over 10% of the pregnant women were both anemic and deficient in B-complex vitamins, whereas 22% of women were both anemic and zinc deficient. Only 4% of women had no deficiency, whereas approximately 20% of the women had 2, 3, or 4 deficiencies. Almost 18% of women had >/=5 deficiencies. Micronutrient status varied by season; it was generally best during the winter months, except for serum vitamin D concentration, which peaked during the hot summer and monsoon months. Women in rural South Asia are likely to begin a pregnancy with multiple micronutrient deficiencies that may vary with seasonality in micronutrient-rich food availability.     

Iron deficiency anemia and proteino-energetic status in woman from 15 to 49 years old in Tunisia

A foodstuffs survey has been carried out on young women aged from 15 to 49 in order to determine the total and available iron supplies, in proteins and in energy so as to establish the link between an iron deficiency and the protein-energy supplies in comparison to the needs required by the FAO and the WHO. The regions studied are the Great Tunis (GT) and the South West (SW) both in urban and rural backgrounds. These two regions have been selected because of the high prevailing rate of deficiency discovered after the 1996/1997 nutritional survey. Women have been divided into two groups: those who have a deficiency and those who don't have. The study concerned 1151 homes therefore about 1468 women and from them 712 are from GT and 756 from SW. The results of foodstuffs survey demonstrated that supply of meat is more elevated in non anemic women than anemic women concerning proteins supplies. A moderate energetic deficit is noticed in non deficient women and those anemic who have an iron deficiency. Women presented anemia have total and available iron deficient and a deficiency in energy supplies.     

Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia

BACKGROUND: Deficiencies of vitamin A, iron, and zinc are prevalent worldwide, affecting vulnerable groups such as lactating women and infants. However, the existence of concurrent deficiencies has received little attention. OBJECTIVE: The aim was to investigate the extent to which deficiencies of vitamin A, iron, and zinc coexist and the nutritional relation between lactating mothers and their infants. DESIGN: In a cross-sectional survey in rural West Java, Indonesia, 155 lactating mothers and their healthy infants were assessed anthropometrically and blood, urine, and breast-milk samples were obtained. RESULTS: Marginal vitamin A deficiency was found in 54% of the infants and 18% of the mothers. More than 50% of the mothers and infants were anemic and 17% of the infants and 25% of the mothers were zinc deficient. There was a strong interrelation between the micronutrient status of the mothers and infants and the concentrations of retinol and beta-carotene in breast milk. Vitamin A deficiency in infants led to an increased risk of anemia and zinc deficiency (odds ratios: 2.5 and 2.9, respectively), whereas in mothers the risk of anemia and iron deficiency (odds ratios: 3.8 and 4.8, respectively) increased. In infants, concentrations of insulin-like growth factor I were related to concentrations of plasma retinol and beta-carotene but not to zinc. CONCLUSIONS: Micronutrient deficiencies were prevalent in West Java. The micronutrient status of lactating mothers and that of their infants were closely related; breast milk was a key connecting factor for vitamin A status. Furthermore, concurrent micronutrient deficiencies appeared to be the norm.     

贫血孕妇营养状况及免疫水平的调查分析

目的检测贫血孕妇体内维生素A(VitA)、核黄素(VitB2)和铁(Fe)的水平,为在人群中科学合理地实施对VitA、VitB2和Fe的联合干预提供理论依据。方法随机抽取340名贫血孕妇和150名非贫血孕妇,采用24h回顾法进行膳食调查,并检测受试者体内VitA、VitB2和Fe的水平。结果贫血组孕妇膳食中VitA、VitB2的摄入量分别仅达到推荐量的52.08%和55.88%,明显低于非贫血组孕妇(P<0.01)。贫血组血清VitA、VitB2及Fe的营养状况、免疫指标均明显低于非贫血组(P<0.001)。而同时缺乏3种营养素的孕妇免疫球蛋白水平和淋巴细胞增殖活性明显低于缺乏某一种营养素的孕妇。结论贫血孕妇体内VitA、VitB2和Fe水平较低,由此可影响机体的细胞免疫和体液免疫功能,而3种营养素同时缺乏时影响更明显。     

Influence of prenatal iron and zinc supplements on supplemental iron absorption, red blood cell iron incorporation, and iron status in pregnant Peruvian women

BACKGROUND: It is estimated that 60% of pregnant women worldwide are anemic. OBJECTIVE: We aimed to examine the influence of iron status on iron absorption during pregnancy by measuring supplemental iron absorption, red blood cell iron incorporation, and iron status in pregnant women. DESIGN: Subjects were 45 pregnant Peruvian women (33+/-1 wk gestation), of whom 28 received daily prenatal supplements containing 60 mg Fe and 250 microg folate without (Fe group, n = 14) or with (Fe+Zn group, n = 14) 15 mg Zn, which were were consumed from week 10 to 24 of gestation until delivery. The remaining 17 women (control) received no prenatal supplementation. Iron status indicators and isotopes were measured in maternal blood collected 2 wk postdosing with oral (57Fe) and intravenous (58Fe) stable iron isotopes. RESULTS: Maternal serum ferritin and folate concentrations were significantly influenced by supplementation (P < 0.05). Serum iron was also significantly higher in the Fe than in the Fe+Zn (P < 0.03) or control (P < 0.001) groups. However, the supplemented groups had significantly lower serum zinc concentrations than the control group (8.4+/-2.3 and 10.9+/-1.8 micromol/L, respectively, P < 0.01). Although percentage iron absorption was inversely related to maternal serum ferritin concentrations (P = 0.036), this effect was limited and percentage iron absorption did not differ significantly between groups. CONCLUSIONS: Because absorption of nonheme iron was not substantially greater in pregnant women with depleted iron reserves, prenatal iron supplementation is important for meeting iron requirements during pregnancy.     

Effect of iron supplementation among pregnant women at mother-and-baby clinic of Sidi Bel Abbès, West Algeria

Iron deficiency is the most prevalent nutritional disorder worldwide, especially in developing countries. It occurs when iron absorption does not equal iron requirements plus iron loss. Because iron requirements are especially high in pregnant women, infants, young children, and adolescents, these groups run a high risk of iron-deficiency anemia. In this controlled prospective and longitudinal study of 83 pregnant women, we explored the correlations between various epidemiological characteristics and the onset of anemia. We also looked at the effect of iron supplementation on the hematological parameters among pregnant women with anemia. Blood counts during the first trimester of pregnancy (3 months +/- 2 weeks' gestation) revealed that 31 of the 83 subjects (37.3%) women had anemia (Hb < 11 g/100 ml): 16 moderate (7 g/dl < or = Hb < 10 g/dl) and 15 mild (10 g/dl < or = Hb < 11 g/dl). We detected no cases of severe anemia in our study. Nor did we find a clear correlation between anemia and such factors as age (r = 0.09), number of pregnancies (r = - 0.30), interval between pregnancies (r = 0.03), or number of abortions (r = - 0.18). Nonetheless, iron supplementation of 30 mg/day, prescribed for four months for all the women with anemia (n = 31), improved some of these hematological parameters, increasing hemoglobin and serum iron levels in particular. These two parameters were strongly positively correlated (r = 0.89). We also noted that the red blood cell count (RBC) and the mean corpuscular hemoglobin concentration (MCHC) both increased significantly (p < 0.05) among the anemic women receiving iron supplements. The prevalence of anemia fell from 34.1% in the first trimester, before supplementation, to 6.3% in the third trimester. This finding suggests that the supplementation prevented the fall in hemoglobin and serum iron that occurred among the women without anemia. We think that iron supplementation is a good strategy for treating and preventing anemia during pregnancy.     

Biochemical assessment of the nutritional status of low-income pregnant women of Mexican descent.

Biochemical parameters of nutritional status were investigated in 300 women of Mexican descent during the first and second trimesters of pregnancy. Blood samples were obtained from the women during clinic visits, and measurements were made of serum iron, hemoglobin, hematocrit, serum protein, and transferrin saturation. Additionally, the nutritional status of seven vitamins was determined either by direct assay of the vitamin levels in blood or by measurement of erythrocyte enzyme stimulation. Thiamin and riboflavin were also determined in causal urine samples. Very few women, 8% or less, were classified as being low or deficient in hemoglobin, serum protein, iron, transferrin saturation, vitamin C, carotene, vitamin A, or vitamin B12. Thirty-one percent had low or deficient hematocrit values according to the guidelines used. Folic acid was the most prevalent vitamin deficiency, with 69% of the women having low or deficient serum levels. Based on the erythrocyte enzyme stimulation tests, 22% of the women were low or deficient in thiamin, 29% were low or deficient in riboflavin, and 9% were deficient in pyridoxine. None of the women had a low urinary excretion of thiamin, but 8% had excretion values of riboflavin below the acceptable level. Fewer deficiencies of thiamin and serum folic acid were observed in women taking vitamin and mineral supplements than in those who were not.     

正常孕妇与其新生儿脐血血清铁蛋白水平测定分析

目的探讨孕妇铁贮备状态对新生儿铁贮备的影响，为正常孕妇及其新生儿铁缺乏的诊断提供一个有用易行的指标。方法分别采用瑞士Roche Modular Analytics E170型自动电化学发光免疫分析仪和日本Sysmex XT-1800i五分类血液细胞分析仪测定81例正常非孕育龄妇女及334例足月临产正常孕妇与其新生儿脐血的铁蛋白和血红蛋白。结果临产孕妇血红蛋白、铁蛋白含量明显低于正常非孕育龄妇女（t=12．89、14．48，P〈0．01），贫血组血红蛋白、铁蛋白含量低于非贫血组（t=22．61、4．64，P〈0．01），贫血组新生儿脐血铁蛋白含量低于非贫血组新生儿脐血铁蛋白含量（t=1．99，P〈0．05）。结论及早筛查孕妇铁蛋白含量，可以间接了解新生儿铁的贮备，并纠正孕妇缺铁，有效防治孕妇及新生儿铁缺乏。     

晚期孕妇铁、锌、铜营养状况与贫血的关系

目的：了解晚期孕妇血清铁、锌、铜营养状况和缺铁性贫血的关系。方法：对在1999年12月-2000年2月期间来福建省福清市医院和妇幼保健院门诊检查的242名晚期孕妇采取空腹静脉血10ml，测定血红蛋白（Hb）、红细胞压积（Hct）和血清铁（Fe）、锌（Zn）、铜（Cu）、铁蛋白（SF）、可溶性转铁蛋白受体（s-TfR）的含量，同时测量身高、体重等指标。结果：贫血孕妇的血清Fe、Cu、SF含量显低于非贫血孕妇，而血清锌、s-TfR含量两组差异无显性。结论：孕妇贫血不仅与缺铁有关，同时伴有铜等微量元素的缺乏。     

Response of hemoglobin, serum ferritin, and serum transferrin receptor during iron supplementation in pregnancy: a prospective study

OBJECTIVE: We evaluated the effect of iron supplementation on biochemical indicators of iron status, namely hemoglobin (Hb), serum ferritin (SF), and serum transferrin receptor (sTfR), during pregnancy. METHODS: A prospective study was conducted in 73 pregnant women who received daily supplements of 60 mg of iron and 500 microg of folic acid for 100 d from 19 wk of gestation. The indicators of iron status (Hb, SF, and sTfR) at 19, 27, and 35 wk of gestation were analyzed. The response of iron status indicators to iron supplementation was assessed in the cohort and in pregnant women who were anemic (n = 35) and non-anemic (n = 38) at 19 wk. RESULTS: All three indicators of iron status during supplementation (27 and 35 wk) were similar to the presupplementation status. The sTfR as an indicator correlated negatively with presupplementation Hb levels (r = -0.417). Based on sTfR level in iron-adequate pregnant women, a cutoff value of at least 12.0 mg/L was derived to define iron deficiency in pregnancy. When the response was tested in anemic pregnant women, iron supplementation improved mean Hb (P < 0.05) at the end of 35 wk (96 +/- 8.8 to 110 +/- 20.2 g/L) of gestation, with no change in SF. Conversely, non-anemic pregnant women showed a significant increase in SF and a decrease in Hb (122 +/- 11.6 to 112 +/- 15.2 g/L) at 35 wk of gestation. A significant effect of iron intake on sTfR was seen only among iron-deficient anemic women. CONCLUSIONS: These observations suggest that, during pregnancy, sTfR responds to iron supplementation when there is iron-deficiency anemia and therefore can be used as an indicator.     

Effects of wheat flour fortified with different iron fortificants on iron status and anemia prevalence in iron deficient anemic students in Northern China

OBJECTIVES: To compare the effects of wheat flours fortified with NaFeEDTA, FeSO4 and elemental iron (electrolytic iron), in improving iron status in anemic students. METHODS: Four hundreds anemic students (11 to 18 years old) were divided into four groups and given wheat flour fortified with different iron fortificants at different concentrations: control group (no added iron); NaFeEDTA group (20 mg Fe/kg); FeSO4 group (30 mg Fe/kg); and elemental iron group (60 mg Fe/kg). The trial lasted for 6 months and the following parameters were examined every 2 months: whole blood hemoglobin, free erythrocyte protoporphyrin, serum ferritin, serum iron, total iron binding capacity and transferrin receptor. RESULTS: The flour consumption in the 4 groups was 300-400 g/person/day, accounted for 70% of total cereal consumption in the diets. There were no significant differences in flour consumption among the 4 groups. Blood hemoglobin level increased in all the 3 intervened groups, but the increment in the NaFeEDTA group was significantly higher and earlier than the other 2 groups; and only 1% of the subjected remained anemic at the end of the trial in the NaFeEDTA group, while 40% and 60% of the subjects in the FeSO4 and electrolytic iron group remained anemic, respectively. The order of improvements in free erythrocyte protoporphyrin, serum ferritin and transferring receptor levels were: NaFeEDTA > FeSO4 > electrolytic iron. No significant changes were found in the control group on all the tested parameters during the trial. CONCLUSIONS: The results indicated that even NaFeEDTA was added at a lower level, it has better effects than FeSO4 and elemental iron on controlling iron deficiency anemia and improving iron status in anemic children; while elemental iron was the least effective.     

Iron deficiency anemia: Pregnancy outcomes with or without iron supplementation

Objective

To estimate the efficacy of iron supplementation in anemic pregnant women on the basis of occurrence of pregnancy complications and birth outcomes.

Methods

Comparison of the occurrence of medically recorded pregnancy complications and birth outcomes in pregnant women affected with medically recorded iron deficiency anemia and iron supplementation who had malformed fetuses/newborns (cases) and who delivered healthy babies (controls) in the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities.

Results

Of 22 843 cases with congenital abnormalities, 3242 (14.2%), while of 38 151 controls, 6358 (16.7%) had mothers with anemia. There was no higher rate of preterm births and low birth weight in the newborns of anemic pregnant women supplemented by iron. However, anemic pregnant women without iron treatment had a significantly shorter gestational age at delivery with a somewhat higher rate of preterm births but these adverse birth outcomes were prevented with iron supplementation. The rate of total and some congenital abnormalities was lower than expected and explained mainly by the healthier lifestyle and folic acid supplements. The secondary findings of the study showed a higher risk of constipation-related hemorrhoids and hypotension in anemic pregnant women with iron supplementation.

Conclusion

A higher rate of preterm birth was found in anemic pregnant women without iron treatment but this adverse birth outcome was prevented with iron supplementation. There was no higher rate of congenital abnormalities in the offspring of anemic pregnant women supplemented with iron and/or folic acid supplements.