A randomized comparison of routine versus selective iron supplementation during pregnancy

Iron supplementation during pregnancy

There is world-wide concern that women of childbearing age cannot meet the increased iron needs during pregnancy. In the industrial world however, iron supplementation during pregnancy is a controversial issue. On the one hand, selective iron supplementation after iron status assessment has been recommended because not all women need iron, and compliance is likely to be better when an individual's need is recognized. On the other hand, routine iron supplementation to all women in the second half of pregnancy has been advocated in order to reach all women without the difficulties associated with assessment of iron status. Pregnant women could possibly meet their iron needs by increasing iron absorption efficiency. Although in that case, dietary counselling may prevent anaemia during pregnancy, supplementation with iron will be necessary to cure iron-deficiency anaemia.

Iron supplementation in pregnancy. General practitioners' compliance with official recommendations

OBJECTIVE--To compare general practitioners' routines regarding iron supplementation in pregnancy with national recommendations.

DESIGN

Mailed questionnaire to general practitioners.

SETTING

A county in western Norway.

SUBJECTS

184 general practitioners.

MAIN OUTCOME MEASURES

Descriptive registration of reported routines regarding assessment and supplementation of iron.

RESULTS

11% of general practitioners reported complete adherence to the national programme recommending iron supplements for everyone in the second half of pregnancy and use of s-ferritin estimation if Hb falls below 11 g/dl. 36% of the doctors prescribed iron supplements routinely irrespective of iron status. 87% reported use of s-ferritin estimation in antenatal care; usually on indication of low Hb, almost 20% as a routine screening in all pregnancies.

CONCLUSION

General practitioners' compliance with national recommendations for iron supplementation in pregnancy is very low and probably reveals a need both for a review of the national recommendations and for an approach to increase compliance with given standards.