- Autores: Pena-Rosas JP, Nesheim MC, Garcia-Casal MN, Crompton DW, Sanjur D, Viteri FE, Frongillo EA, Lorenzana P.
- Referencia: J Nutr. 2004 May;134(5):1099-104.
Daily iron supplementation programs for pregnant women recommend amounts of iron that are considered by some to be excessive, and either lower-dose or less frequent iron supplementation regimens have been proposed. A randomized, placebo-controlled study was performed to assess and compare the relative effectiveness of a weekly (WS) or twice weekly (TW) iron supplementation schedule in maintaining or achieving hemoglobin (Hb) levels at term considered to carry minimal maternal and fetal risk (90-130 g/L). Pregnant women (n = 116) at wk 10-30 of gestation (63 WS and 53 TW) were enrolled in the study (52 in WS and 44 TW completed the study). Women were randomly allocated to receive a 120-mg oral dose of iron as ferrous sulfate and 0.5 mg of folic acid weekly (n = 52) or 60 mg iron and 0.25 mg folic acid and a placebo twice weekly (n = 44). Hb, hematocrit, serum ferritin, and transferrin saturation were estimated at baseline and at 36-39 wk of gestation. Baseline dietary data and the presence and intensity of intestinal helminthic infections were assessed. The duration of supplementation was 14 +/- 4 wk and the median level of adherence was 60.5%. Hb concentrations improved in women following the TW regimen and in women following WS who had low baseline Hb levels. About 89% of WS women and 95% of TW women maintained Hb levels at term (between 90 g/L and 130 g/L), a range associated with optimal pregnancy outcomes. One woman in the TW group exhibited higher Hb levels that potentially carried perinatal risk (>130 g/L). Intermittent iron and folic acid supplementation may be a valid strategy when used as a preventive intervention in prenatal care settings.