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Twice-Weekly Iron Supplements During Pregnancy Equally as Effective as Daily Regime for Infant Development

Update Date: Jun 18, 2013 05:00 PM EDT

For pregnant women, taking iron supplements everyday may be just as effective as taking them twice a week.

A new study reveals that daily supplementation of iron tablets does not provide any benefits in birth weight or improved infant growth compared to twice weekly supplementation.

What's more, researchers found that twice-weekly supplements may actually be better because it improved adherence rates in pregnant women and improved development in infants aged six months.

Researchers said these findings are important because anemia is a widespread global health problem.  Researchers estimate that over 2 billion people in the world have anemia, a condition in which the blood does not supply the body with enough oxygen because of low levels of hemoglobin, the iron-containing pigment that enables red blood cells to carry oxygen.  Furthermore, side effects and costs of daily iron supplementation are challenges to treatment.

Lead researcher Beverley Biggs from the University of Melbourne in Australia conducted a cluster randomized controlled trial of 1,258 pregnant women in a semi-rural region of Vietnam.  The women were divided into three groups and were assigned to receive daily iron-folic acid supplementation, twice weekly iron-folic acid supplementation, or twice weekly iron-folic acid supplementation plus micronutrients

The study revealed that birth weight was similar in all supplement groups, and there were also no differences in rates of prematurity, stillbirth or neonatal death.  There were also no differences in the levels of infant hemoglobin, prevalence of anemia, or growth rates at six months of age.

However, the findings revealed that infants born to mothers in the twice weekly iron-folic acid supplement group had improved cognitive development compared to infants born to mothers in the daily supplement group.  The study also found that adherence rates were significantly higher in the twice-weekly iron-folic acid supplement group compared to the once daily regime.

"We have shown that twice weekly antenatal [iron-folic acid supplementation] or [multiple micronutrient supplementation] in an area of Southeast Asia with low anemia prevalence did not produce a clinically important difference in birth weight or infant growth outcomes, compared to daily antenatal [iron-folic acid supplementation]," researchers wrote in the study.

"Our finding of a significant improvement in infant cognitive outcome at 6 months of age following twice weekly antenatal [iron-folic acid supplementation] requires further exploration, and provides additional support for the use of intermittent over daily antenatal [iron-folic acid supplementation] regimes in populations with low rates of iron deficiency," they concluded.

The findings are published in the journal PLOS Medicine.

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