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Single dose of iron as effective as double dose in iron-deficient pregnant women

11 Sep 2017

There appears to be little benefit to doubling the dose of elemental iron in pregnant women with iron-deficiency anaemia, with a recent study showing that a double dose does not increase haemoglobin and ferritin concentrations to a greater degree compared with a single dose, according to a study.

The prospective randomized controlled trial included 160 iron-deficient pregnant women who were assigned to groups receiving one (n=160) or two (n=164) capsules of daily iron supplement, containing 34 mg of ferrous sulphate, from 17 weeks until 6 weeks postpartum.

Haemoglobin at 35 weeks was the main outcome of interest. Ferritin at 35 weeks, haemoglobin during pregnancy and postpartum, birth weights, preterm birth rate, gastrointestinal side effects, intravenous iron administration and compliance were also assessed as secondary outcomes.

Mean levels of haemoglobin and ferritin at baseline were similar between the single- and double-dose groups (haemoglobin, 10.1 g dl−1 in both; ferritin, 9.3 vs 9.4 ng l−1, respectively). At week 35, mean haemoglobin levels increased but remained low at 10.8 g dl−1 in both groups.

Ferritin concentrations at week 35 increased to 13.8 ng l−1 in the single-dose group and to 14.2 ng l−1 in the double-dose group, although the difference was not significant. No significant between-group differences were noted in the rest of the secondary outcomes investigated.

Researchers pointed out that the modest increase in haemoglobin and ferritin concentrations observed in women receiving a double dose as opposed to a single dose may be explained by the involvement of hepcidin, the key regulator of systemic iron balance in mammals.

It has been previously reported that iron supplements at doses of 60 mg or higher increase hepcidin, resulting in decreased iron absorption and bioavailability. [Blood 2015;126:1981–1989]

The present data suggest that doses of iron, exceeding the Centers for Disease Control and Prevention recommendation of 30 mg per day, do not further improve maternal iron status during pregnancy, researchers said.

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Most Read Articles
5 days ago
Combining the DASH (Dietary Approaches to Stop Hypertension) diet with low sodium intake reduces systolic blood pressure (SBP) in individuals with pre- and stage 1 hypertension, with progressively higher reductions at greater levels of baseline SBP, a recent study has shown.
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Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
4 days ago
Tadalafil may not be effective for reducing the decline in ambulatory ability in boys with Duchenne muscular dystrophy (DMD), as shown in a recent study.
01 Dec 2017
At a symposium during the 25th Congress of the Obstetrical and Gynaecological Society of Malaysia in Kuala Lumpur, Professor Susan Davis discussed the unique implications of women living decades beyond menopause, and how healthcare professionals can best manage menopausal symptoms in the short and long term.