The effect of iron supplementation on maternal iron deficiency anemia does not differ by baseline anemia type among Tanzanian pregnant women without severe iron deficiency anemia.
Study Goal
The researchers aimed to determine whether anemia type (IDA vs. NIDA) modifies the risk of pregnancy/newborn outcomes and the effectiveness of prenatal iron supplementation.
Results Summary
Iron supplementation improved delivery hemoglobin levels across all groups, with the greatest effect in the IDA group (16 g/L increase). No significant differences in adverse outcomes (e.g., stillbirths, preterm birth) were found between IDA and NIDA groups compared to non-anemic women.
Population
1,450 HIV-negative pregnant women in Tanzania with gestational age <27 weeks, hemoglobin >85 g/L, and ferritin >12 µg/L.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
- | decrease | delivery hemoglobin | baseline IDA group | 15 g/L (95% CI 10.9, 19.3) | was lower | #1 |
- | decrease | delivery hemoglobin | baseline NIDA group | 7.3 g/L (95% CI 3.1, 11.5) | was lower | #2 |
- | no change | anemia severity, iron deficiency, placental malaria, stillbirths, perinatal mortality, birthweight, and preterm birth | baseline NIDA group (vs. non-anemia) compared to the baseline IDA group (vs. non-anemia) | - | were not different | #3 |
iron supplementation | increase | delivery hemoglobin | non-anemia group | 8 g/L (95% CI 6, 11) | difference in the mean delivery hemoglobin | #4 |
iron supplementation | increase | delivery hemoglobin | NIDA group | 7 g/L (95% CI 2, 13) | difference in the mean delivery hemoglobin | #5 |
iron supplementation | increase | delivery hemoglobin | IDA group | 16 g/L (95% CI 10, 22) | difference in the mean delivery hemoglobin | #6 |
iron supplementation | neutral | - | pregnant women with NIDA | - | is effective | #7 |
PURPOSE: Whether anemia type modifies the risk of pregnancy and newborn outcomes and the effectiveness of iron supplementation is unclear. We examined the association of iron deficiency anemia (IDA) and non-iron deficiency anemia (NIDA) on the risks of these outcomes and the extent to which anemia type modifies the impact of prenatal iron supplementation. METHODS: This was a secondary analysis of a placebo-controlled trial of iron supplementation among 1450 HIV-negative women in Tanzania. Eligibility criteria included gestational age < 27 weeks, hemoglobin > 85 g/L, and ferritin > 12 µg/L. Individuals were categorized as non-anemia, IDA or NIDA using hemoglobin, ferritin and CRP. Analyses were conducted using regression models and likelihood ratio tests. RESULTS: Compared to the non-anemia group, delivery hemoglobin was lower by 15 g/L (95% CI 10.9, 19.3) in the baseline IDA group, and 7.3 g/L (95% CI 3.1, 11.5) in the baseline NIDA group. The RRs of anemia severity, iron deficiency, placental malaria, stillbirths, perinatal mortality, birthweight, and preterm birth were not different among women in the baseline NIDA group (vs. non-anemia) compared to the baseline IDA group (vs. non-anemia). The difference in the mean delivery hemoglobin for iron supplementation and placebo arms was 8 g/L (95% CI 6, 11) in the non-anemia group, 7 g/L (95% CI 2, 13) in the NIDA group, and 16 g/L (95% CI 10, 22) in the IDA group. CONCLUSION: Iron supplementation is effective even among pregnant women with NIDA. TRIAL REGISTRATION: NCT01119612 (May 7, 2010).