Content area
Full Text
European Journal of Clinical Nutrition (2009) 63, 183190
& 2009 Macmillan Publishers Limited All rights reserved 0954-3007/09 $32.00 http://www.nature.com/ejcn
Web End =www.nature.com/ejcn
ORIGINAL ARTICLE
Should we lower the dose of iron when treating anaemia in pregnancy? A randomized doseresponse trial
SJ Zhou1,2, RA Gibson1,3, CA Crowther4 and M Makrides1,2
1Child Nutrition Research Centre, Flinders Medical Centre and Womens & Childrens Hospital, Child Health Research Institute, North Adelaide, SA, Australia; 2School of Paediatrics & Reproductive Health, University of Adelaide, Adelaide, SA, Australia; 3School of Agriculture, Food & Wine, University of Adelaide, Waite Campus, Urrbrae, SA, Australia and 4Maternal Perinatal Clinical Trials Unit, School of Paediatrics & Reproductive Health, University of Adelaide, Womens & Childrens Hospital, North Adelaide, SA, Australia
Background/Objectives: To compare the efficacy and side effects of low-dose vs high-dose iron supplements to correct anaemia in pregnancy.
Subjects/Methods: One hundred and eighty women with anaemia (haemoglobin o110 g l 1) in mid-pregnancy. The women were randomly allocated to 20; 40 or 80 mg of iron daily for 8 weeks from mid-pregnancy.
Results: One hundred and seventy-nine (99%) women completed the trial. At the end of treatment, there was a clear dose response of increasing mean haemoglobin concentration with iron dose (111713 g l 1 at 20 mg per day, 114711 g l 1 at 40 mg per day and 119712 g l 1 at 80 mg per day, P 0.006). However, the incidence of anaemia did not differ statistically
between groups. Compared with women in the 80 mg iron group, the odds ratio of anaemia was 1.9 (95% CI: 0.8, 4.3, P 0.130) and 1.1 (95% CI: 0.5, 2.6, P 0.827), respectively, for women in the 20 mg iron group and the 40 mg iron group.
The incidence of gastrointestinal side effects was significantly lower for women in the 20 mg iron group compared with women in the 80 mg iron group; the odds ratio was 0.4 (95% CI: 0.2, 0.8, P 0.014) for nausea, 0.3 (95% CI: 0.2, 0.7, P 0.005) for
stomach pain and 0.4 (95% CI: 0.2, 0.9, P 0.023) for vomiting.
Conclusions: Low-dose iron supplements may be effective at treating anaemia in pregnancy with less gastrointestinal side effects compared with high-dose supplements.
European Journal of Clinical Nutrition (2009) 63, 183190; doi:http://dx.doi.org/10.1038/sj.ejcn.1602926