Adapting iron dose supplementation in pregnancy for greater effectiveness on mother and child health: protocol of the ECLIPSES randomized clinical trial.
Study Goal
The researchers aimed to determine the optimal iron supplementation dose based on early pregnancy hemoglobin levels to promote maternal and infant health.
Results Summary
The study is structured as a randomized clinical trial but does not yet report conclusive outcomes regarding the effectiveness of different iron doses.
Population
878 non-anemic pregnant women in early gestation and their newborns from 10 primary care centers in Catalunya, Spain.
Effective Dosage
20 mg/d, 40 mg/d, or 80 mg/d depending on hemoglobin levels.
Duration
Not specified in the abstract.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
iron supplementation | no change | anemia | pregnancies | around 20% | does not preempt anemia | #1 |
iron supplementation | increase | hemoconcentration | pregnancies | 15% | risk of hemoconcentration | #2 |
iron supplementation | decrease | mother-child wellbeing | mother-child | - | prejudices the mother-child wellbeing | #3 |
iron supplementation of 40 or 80 mg/d | increase | maternal and offspring health | non-anemic pregnant women at early gestation stage with Hb from 110 to 130 g/L | - | determine the highest level of effectiveness | #4 |
iron supplementation of 40 or 20 mg/d | increase | maternal and offspring health | non-anemic pregnant women at early gestation stage with Hb >130 g/L | - | determine the highest level of effectiveness | #5 |
BACKGROUND: Currently, there is no consensus regarding iron supplementation dose that is most beneficial for maternal and offspring health during gestation. Recommended iron supplementation dose does not preempt anemia in around 20% of the pregnancies, nor the risk of hemoconcentration in 15%. This deficit, or excess, of iron prejudices the mother-child wellbeing. Therefore the aims of the study are to determine the highest level of effectiveness of iron supplementation adapted to hemoglobin (Hb) levels in early pregnancy, which would be optimum for mother-child health. DESIGN: Randomized Clinical Trial (RCT) triple-blindedSetting: 10 Primary Care Centers from Catalunya (Spain)Study subjects: 878 non-anemic pregnant women at early gestation stage, and their subsequent newborns METHODS: The study is structured as a RCT with 2 strata, depending on the Hb levels before week 12 of gestation. Stratum #1: If Hb from 110 to 130 g/L, randomly assigned at week 12 to receive iron supplement of 40 or 80 mg/d. Stratum #2: If Hb >130 g/L, randomly assigned at week 12 to receive iron supplement of 40 or 20 mg/d. MEASUREMENTS: In the mother: socio-economic data, clinical history, food item frequency, lifestyle and emotional state, and adherence to iron supplement prescription. Biochemical measurements include: Hb, serum ferritin, C reactive protein, cortisol, and alterations in the HFE gene (C282Y, H63D). In children: ultrasound fetal biometry, anthropometric measurements, and temperament development.Statistical analyses, using the SPSS program for Windows, will include bivariate and multivariate analyses adjusted for variables associated with the relationship under study. DISCUSSION: Should conclusive outcomes be reached, the study would indicate the optimal iron supplementation dose required to promote maternal and infant health. These results would contribute towards developing guidelines for good clinical practice.