Prenatal iron containing supplements provided to Chinese women with no or mild anemia had no effect on hemoglobin concentration in post-partum women or their infants at 6 and 12 months of age.
Study Goal
The researchers aimed to compare the effects of folic acid alone, iron-folic acid, and multiple micronutrients on hemoglobin levels in post-partum women and their infants, and to assess the influence of maternal hemoglobin concentration at enrollment.
Results Summary
Prenatal iron-folic acid (IFA) and multiple micronutrients (MMN) did not reduce anemia prevalence in post-partum women or their infants compared to folic acid alone, regardless of baseline maternal hemoglobin levels. Anemia rates remained similar across all groups at 4-6 weeks post-partum and at 6 and 12 months of age in infants.
Population
18,775 nulliparous women in China with hemoglobin >100 g/L (no or mild anemia) and their infants.
Effective Dosage
FA (400 μg daily), IFA (FA + 30 mg Fe daily), MMN (FA + Fe + 13 micronutrients daily).
Duration
From before 20 gestational weeks until delivery.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
iron-folic acid (IFA) | no change | prevalence of anemia | post-partum women | 27.2% vs 26.8% | did not affect | #1 |
multiple micronutrients (MMN) | no change | prevalence of anemia | post-partum women | 27.2% vs 26.3% | did not affect | #2 |
iron-folic acid (IFA) | no change | anemia prevalence | infants | 6.9% vs 6.7% | did not affect | #3 |
multiple micronutrients (MMN) | no change | anemia prevalence | infants | 6.9% vs 6.7% | did not affect | #4 |
prenatal IFA and MMN | no change | anemia | women post-partum | - | did not affect | #5 |
prenatal IFA and MMN | no change | anemia | their infants | - | did not affect | #6 |
BACKGROUND: Although prenatal iron-containing supplements have been associated with lower anemia prevalence in later pregnancy, few trials have examined the effect of supplements on the anemia status of post-partum women and their infants. OBJECTIVE: We compared the effects of folic acid alone (FA), iron-folic acid (IFA) and multiple micronutrients (MMN) when provided to pregnant women with no or mild anemia on the hemoglobin levels of post-partum women and their infants at 6 and 12 months of age. We also examined the potential modifying effect of maternal hemoglobin concentration at enrollment. METHODS: A double-blind randomized controlled trial was conducted in China; 18,775 nulliparous women with a hemoglobin concentration > 100 g/L were randomly assigned to receive daily FA (400 μg); IFA (FA, Fe 30 mg), or MMN (FA, Fe and 13 micronutrients) from before 20 gestational weeks until delivery. RESULTS: Compared with daily prenatal FA, supplementation with IFA or MMN did not affect the prevalence of anemia at 4-6 weeks post-partum (27.2%, 26.8%, and 26.3%, respectively). At 6 months of age, the anemia prevalence in infants was 6.9%, 6.7%, and 6.7%, respectively. Findings were similar at 12 months of age. Among both post-partum women and infants, findings were similar across all levels of hemoglobin at enrollment. CONCLUSIONS: Compared to FA alone, prenatal IFA and MMN provided to women with no or mild anemia did not affect anemia in women post-partum or their infants regardless of baseline maternal hemoglobin concentration at enrollment.