Skip to main content

Advertisement

Log in

Iron supplementation in pregnancy—does the preparation matter?

  • Original Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To assess the use, side effects and discontinuation rates of iron preparations during pregnancy.

Design

Six hundred and twelve randomly selected postpartum women completed a questionnaire on iron supplement use in the second and third trimesters.

Results

Of the 517 women (84.5%) reported using iron supplements, 453 were eligible for the study. The most common preparation was ferrous fumarate (46.8%, P < 0.01), followed by ferrous sulfate (31.8%), ferric polymaltose (12.4%), and ferric bisglycinate (7.3%). Almost half the participants (45%) reported at least one adverse effect, especially constipation (27.4%, P < 0.01), nausea (10.8%). Multivitamin preparations and ferric bisglycinate were associated with the fewest side effects (23.7, 21.2% respectively, P < 0.01), and ferrous fumarate and immediate-release ferrous sulfate with the most (56.3, 53.7% respectively). Eighty-three women discontinued their originally prescribed iron preparation, mainly (89%) due to side effects. Discontinuation rates were lowest for the multivitamin and ferric bisglycinate (10.5, 9.1%, respectively). In most cases, the specific preparation was recommended by the women’s physician (76%).

Conclusion

Ferrous fumarate-containing multivitamin preparations and ferric bisglycinate, although infrequently recommended as the first-line of iron supplementation, may be associated with less side effects and better compliance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. World Health Organization (1992) The prevalence of anaemia in women: a tabulation of available information. WHO, Geneva

    Google Scholar 

  2. Macgregor M (1963) Maternal anaemia as a factor in prematurity and perinatal mortality. Scott Med J 8:134

    Google Scholar 

  3. Scholl TO, Hediger ML (1994) Anemia and iron-deficiency anemia: compilation of data on pregnancy outcome (discussion 500S–501S). Am J Clin Nutr 59(2 Suppl):492S–500S

    PubMed  CAS  Google Scholar 

  4. Levy A, Fraser D, Katz M, Mazor M, Sheiner E (2005) Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol 122(2):182–186

    Article  PubMed  Google Scholar 

  5. Stoltzfus RD, Dreyfuss ML (2000) Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. International Nutritional Anemia Consultative Group (INACG)

  6. Pena-Rosas JP, Viteri FE (2006) Effects of routine oral iron supplementation with or without folic acid for women during pregnancy. Cochrane Database Syst Rev 3:CD004736

    PubMed  CAS  Google Scholar 

  7. Casanueva E, Viteri FE, Mares-Galindo M, Meza-Camacho C, Loria A, Schnaas L et al (2006) Weekly iron as a safe alternative to daily supplementation for nonanemic pregnant women. Arch Med Res 37(5):674–682

    Article  PubMed  CAS  Google Scholar 

  8. Hemminki E, Merilainen J (1995) Long-term follow-up of mothers and their infants in a randomized trial on iron prophylaxis during pregnancy. Am J Obstet Gynecol 173(1):205–209

    Article  PubMed  CAS  Google Scholar 

  9. Schultink W, van der Ree M, Matulessi P, Gross R (1993) Low compliance with an iron-supplementation program: a study among pregnant women in Jakarta, Indonesia. Am J Clin Nutr 57(2):135–139

    PubMed  CAS  Google Scholar 

  10. Nordeng H, Eskild A, Nesheim BI, Aursnes I, Jacobsen G (2003) Guidelines for iron supplementation in pregnancy: compliance among 431 parous Scandinavian women. Eur J Clin Pharmacol 59(2):163–168

    PubMed  CAS  Google Scholar 

  11. Yu SM, Keppel KG, Singh GK, Kessel W (1996) Preconceptional and prenatal multivitamin-mineral supplement use in the 1988 National Maternal and Infant Health Survey. Am J Public Health 86(2):240–242

    Article  PubMed  CAS  Google Scholar 

  12. DeMaeyer EM, Dallman P, Gumey JM, Hallberg L, Sood SK, Srikantia SG (1989) Preventing and controlling iron deficiency anaemia through primary health care. WHO, Geneva

    Google Scholar 

  13. Hansen CM (1994) Oral iron supplements. Am Pharm NS34(3):66–71

    PubMed  CAS  Google Scholar 

  14. Rybo G, Solvell L (1971) Side-effect studies on a new sustained release iron preparation. Scand J Haematol 8(4):257–264

    Article  PubMed  CAS  Google Scholar 

  15. Brock C, Curry H, Hanna C, Knipfer M, Taylor L (1985) Adverse effects of iron supplementation: a comparative trial of a wax-matrix iron preparation and conventional ferrous sulfate tablets. Clin Ther 7(5):568–573

    PubMed  CAS  Google Scholar 

  16. Jacobs P, Wood L, Bird AR (2000) Erythrocytes: better tolerance of iron polymaltose complex compared with ferrous sulphate in the treatment of anaemia. Hematol 5(1):77–83

    CAS  Google Scholar 

  17. Pineda O, Ashmead HD (2001) Effectiveness of treatment of iron-deficiency anemia in infants and young children with ferrous bis-glycinate chelate. Nutrition 17(5):381–384

    Article  PubMed  CAS  Google Scholar 

  18. Jacobs P, Fransman D, Coghlan P (1993) Comparative bioavailability of ferric polymaltose and ferrous sulphate in iron-deficient blood donors. J Clin Apher 8(2):89–95

    Article  PubMed  CAS  Google Scholar 

  19. Bezkorovainy A (1989) Biochemistry of nonheme iron in man. II. Absorption of iron. Clin Physiol Biochem 7(2):53–69

    PubMed  CAS  Google Scholar 

  20. Everson GT (1992) Gastrointestinal motility in pregnancy. Gastroenterol Clin North Am 21(4):751–76

    PubMed  CAS  Google Scholar 

  21. Greenhalf JO, Leonard HS (1973) Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner 210(256):259–263

    PubMed  CAS  Google Scholar 

  22. Klebanoff MA, Koslowe PA, Kaslow R, Rhoads GG (1985) Epidemiology of vomiting in early pregnancy. Obstet Gynecol 66(5):612–616

    PubMed  CAS  Google Scholar 

  23. FitzGerald CM (1984) Nausea and vomiting in pregnancy. Br J Med Psychol 57(Pt 2):159–165

    PubMed  Google Scholar 

  24. Tierson FD, Olsen CL, Hook EB (1986) Nausea and vomiting of pregnancy and association with pregnancy outcome. Am J Obstet Gynecol 155(5):1017–1022

    PubMed  CAS  Google Scholar 

  25. Hyder SM, Persson LA, Chowdhury AM, Ekstrom EC (2002) Do side-effects reduce compliance to iron supplementation? A study of daily- and weekly-dose regimens in pregnancy. J Health Popul Nutr 20(2):175–179

    PubMed  Google Scholar 

  26. Makrides M, Crowther CA, Gibson RA, Gibson RS, Skeaff CM (2003) Efficacy and tolerability of low-dose iron supplements during pregnancy: a randomized controlled trial. Am J Clin Nutr 78(1):145–153

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yariv Yogev.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Melamed, N., Ben-Haroush, A., Kaplan, B. et al. Iron supplementation in pregnancy—does the preparation matter?. Arch Gynecol Obstet 276, 601–604 (2007). https://doi.org/10.1007/s00404-007-0388-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-007-0388-3

Keywords

Navigation