Daily versus intermittent iron supplementation in pregnant women: Hematological and pregnancy outcome

Aim: To compare the hematological parameters and pregnancy outcome in women receiving daily versus weekly iron supplements during pregnancy. Methods: A prospective randomized controlled study was carried out at the Department of Obstetrics and Gynaecology of the All India Institute of Medical Sciences, New Delhi, India, during which 111 women were randomized to receive either 100 mg elemental iron daily (n = 55) or 200 mg elemental iron weekly (n = 56). Hemogram and serum ferritin level estimation were carried out at the beginning of pregnancy and within the 32-34-week period of gestation. Side-effects, compliance and the number of tablets consumed were noted for each group. The mean birth weight, period of gestation at delivery and mode of delivery were also compared between the two intervention groups. Results: There was no significant difference in the mean hemoglobin levels between the two intervention groups at the end of an average 17 weeks of iron supplementation. However, among anemic women who received daily supplementation, there was a greater rise in hemoglobin compared with those receiving supplementation weekly. The serum ferritin level was lower in the weekly supplemented group compared with that in the daily. There was no difference in the mean birth weight, period of gestation and mode of delivery between the two groups. Side-effects and non-compliance were significantly higher (P < 0.001) in the daily supplemented group. Conclusions: Weekly iron supplementation is an effective option for prophylaxis in non-anemic pregnant women, but has less than optimal benefit in anemic women.