Efficacy of different doses of daily prophylactic iron supplementation in pregnant women: A systematic review and meta-analysis.
Study Goal
The researchers aimed to determine the optimal daily dosage of iron supplementation for preventing anemia in pregnant women by comparing efficacy and safety outcomes between different dosages.
Results Summary
The study found that 60 mg/day of elemental iron was more effective than 30 mg/day for anemia prophylaxis, while dosages ≤60 mg/day and >60 mg/day were equally effective. The certainty of evidence was rated as moderate for both comparisons.
Population
Pregnant women
Effective Dosage
30 mg/day, 60 mg/day, and >60 mg/day of elemental iron
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
daily supplementation of 60 mg elemental iron | increase | prophylaxis of anemia | pregnant women | - | is more efficacious than | #1 |
daily supplementation of 30 mg elemental iron | decrease | prophylaxis of anemia | pregnant women | - | is less efficacious than | #2 |
daily supplementation of ≤60 mg elemental iron | no change | prophylaxis of anemia | pregnant women | - | is equally efficacious compared to | #3 |
daily supplementation of >60 mg elemental iron | no change | prophylaxis of anemia | pregnant women | - | is equally efficacious compared to | #4 |
iron supplementation (≤60 mg/day group) | no change | blood hemoglobin levels | participants | mean difference 0.01 [-0.11, 0.09] | comparable change in | #5 |
iron supplementation (>60 mg/day group) | no change | blood hemoglobin levels | participants | mean difference 0.01 [-0.11, 0.09] | comparable change in | #6 |
INTRODUCTION: Several randomized controlled trials (RCT) have been conducted in the past to determine the optimum dose of iron supplementation during pregnancy, but there is a lack of consensus among different guidelines regarding the appropriate dosage of iron for prophylaxis during pregnancy. METHODS: Relevant electronic databases were searched to identify publications describing RCTs comparing different daily dosages of iron supplementation during pregnancy. Meta-analysis for various efficacy and safety outcomes such as changes in blood hemoglobin, serum ferritin, serum iron, and serum transferrin saturation, as well as the frequency of adverse effects, was performed using random and fixed effect models suitably depending on the degree of heterogeneity. Two groups were compared: those receiving 60 mg elemental iron or less and those receiving more than 60 mg elemental iron per day. Additionally, the efficacy of those receiving 30 mg elemental iron per day and those receiving 60 mg elemental iron per day were also compared. RESULTS: A to total of 15 RCTs comprising 2726 participants were included in the meta-analysis. Change in blood hemoglobin levels was comparable between the ≤60 mg/day and >60 mg/day group (pooled estimate for mean difference, 0.01 [-0.11, 0.09], p = 0.86, I CONCLUSION: Daily supplementation of 60 mg elemental iron is more efficacious than daily supplementation of 30 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate), and daily supplementation of ≤60 mg elemental iron is equally efficacious compared to daily supplementation of >60 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate). PROESPERO REGISTRATION NO: CRD42023455485.