IMPACT OF IRON SUPPLEMENTATION FREQUENCY ON MATERNAL AND PERINATAL OUTCOMES IN MILD TO MODERATE ANAEMIC PREGNANT WOMEN: AN OBSERVATIONAL ANALYSIS
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Keywords
iron deficiency anaemia, pregnancy, intermittent supplementation, daily iron therapy, maternal outcomes, perinatal outcomes, antenatal care
Abstract
Background: Iron deficiency anaemia (IDA) remains a major contributor to maternal morbidity and adverse perinatal outcomes, particularly in low- and middle-income countries. Daily iron supplementation is the standard regimen; however, gastrointestinal intolerance and poor compliance have led to growing interest in intermittent dosing schedules. Evidence regarding the impact of supplementation frequency on maternal and neonatal outcomes in anaemic pregnant women remains limited.
Objectives: To compare maternal and perinatal outcomes among pregnant women with mild to moderate IDA receiving daily versus twice-weekly oral iron supplementation.
Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynaecology, PGIMS Rohtak, from February 2020 to March 2021. A total of 200 pregnant women between 14–24 weeks of gestation with mild to moderate IDA were enrolled and randomized into two groups:
- Group A (n = 100): Daily supplementation with 100 mg elemental iron + 500 µg folic acid
- Group B (n = 100): Twice-weekly supplementation with two tablets (100 mg iron + 500 µg folic acid each)
Participants were monitored every 4 weeks until delivery. Maternal outcomes included gestational age at delivery, mode of delivery, obstetric complications, postpartum haemorrhage (PPH), and need for blood transfusion. Perinatal outcomes assessed were birth weight, neonatal complications, Apgar scores, and NICU admission. Statistical analysis was performed using t-test and Chi-square test, with p < 0.05 considered significant.
Results: Maternal baseline characteristics were similar between the two groups. Maternal complications occurred in 49% of Group A and 36% of Group B, with no statistically significant difference (p > 0.05). Rates of preterm labour, PROM, fetal distress, and PPH were comparable across both groups. Mode of delivery and transfusion requirements also showed no significant variation. Perinatal outcomes—including mean birth weight (2.59 ± 0.51 kg in Group A vs. 2.71 ± 0.44 kg in Group B), neonatal complications, and NICU admissions—did not differ significantly between regimens.
Conclusion: Twice-weekly iron supplementation provides maternal and perinatal outcomes comparable to daily dosing in mild to moderate IDA. Given its potential advantages in compliance and tolerability, intermittent supplementation may serve as an effective alternative in antenatal care programs.
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Dr Patel Anupam Gangwar
Consultant Gynaecology, City Hospital, Haridwar, Uttarakhand, India
Dr Nirmala Duhan
Professor, Department of Obstetrics and Gynaecology, Pt. BD Sharma PGIMS, Rohtak, Haryana, India
Dr Devvrat Sai
Consultant Cardiology, City Hospital, Haridwar, Uttarakhand, India
Dr Jatin Prajapati
Post Graduate Student, Department of Community Medicine, RNT Medical College, Udaipur, Rajasthan, India