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Cited by 166Iron Metabolism and DisordersHemoglobinopathies and Related DisordersPublic Health and Nutrition

Iron prophylaxis during pregnancy—how much iron is needed? A randomized dose-response study of 20–80 mg ferrous iron daily in pregnant women

Milman, Nils, Bergholt, Thomas, Eriksen, Lisbeth, Byg, Keld‐Erik, Graudal, Niels, Pedersen, Palle, Hertz, Jens·2005·Acta Obstetricia et Gynecologica Scandinavica
DOI 10.1111/j.0001-6349.2005.00610.x
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Abstract

Objective. To determine the lowest dose of iron preventative of iron deficiency and iron deficiency anemia in pregnancy. Methods. A randomized, double‐blind intention‐to‐treat study comprising 427 healthy pregnant women allocated into four groups taking ferrous iron (as fumarate) in doses of 20 mg (n = 105), 40 mg (n = 108), 60 mg (n = 106), and 80 mg (n = 108) from 18 weeks of gestation. Iron status markers [hemoglobin (Hb), serum ferritin, and serum soluble transferrin receptor (sTfR)] were measured at 18 weeks (inclusion), 32 weeks, and 39 weeks of gestation and 8 weeks postpartum. Side effects of iron supplements were recorded. Iron deficiency was defined as serum ferritin <13 µg/l and iron deficiency anemia as serum ferritin <13 µg/l and Hb <5th percentile in iron replete pregnant women. Results. There were no significant differences between variables in the four groups at inclusion. At 32 and 39 weeks of gestation, group 20 mg had significantly lower median serum ferritin (13 and 16 µg/l) than group 40 mg (17 and 21 µg/l), group 60 mg (18 and 23 µg/l), and group 80 mg (21 and 24 µg/l) (p < 0.0001). At 32 and 39 weeks of gestation, group 20 mg had a significantly higher prevalence of iron deficiency (50 and 29%) than group 40 mg (26 and 11%), group 60 mg (17 and 10%), and group 80 mg (13 and 9%) (p < 0.001). The prevalence of iron deficiency anemia at 39 weeks of gestation was significantly higher in group 20 mg (10%) than in group 40 mg (4.5%), group 60 mg (0%), and group 80 mg (1.5%) (p = 0.02). At 32 weeks of gestation, mean Hb in group 20 mg was lower than in group 80 mg (p = 0.06). There were no significant differences in iron status (ferritin, sTfR, and Hb) between group 40, 60, and 80 mg. Postpartum, group 20 mg had significantly lower median serum ferritin than group 40, 60, and 80 mg (p < 0.01). The prevalence of postpartum iron deficiency anemia was low and similar in the four groups. The frequency of gastrointestinal symptoms was not significantly different in the four iron supplement groups and thus not related to the iron dose. Conclusion. In Danish women, a supplement of 40 mg ferrous iron/day from 18 weeks of gestation appears adequate to prevent iron deficiency in 90% of the women and iron deficiency anemia in at least 95% of the women during pregnancy and postpartum.

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Crossref · 10.1111/j.0001-6349.2005.00610.x

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  • A randomized, double-blind trial found that 40 mg/day of supplemental iron in pregnancy prevented iron deficiency in most women and that doses up to 80 mg/day were well tolerated.

    “A randomized, double-blind trial demonstrated that during pregnancy, 40 mg/day of supplemental iron was needed to prevent iron de fi ciency in the majority of women and that up to 80 mg/ day was well-tolerated (43).”

    From Maternal Intake of Supplemental Iron and Risk of Autism Spectrum Disorder (2014) · cites this paper as [43]

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Authors
Milman, N., Bergholt, T., Eriksen, L., Byg, K., Graudal, N., Pedersen, P., & Hertz, J.
Affiliations
  • University of Copenhagen (DK)
  • Gentofte Hospital (DK)
  • Næstved Sygehus (DK)
Corresponding author
Milman, Nils
ORCID
Venue
Acta Obstetricia et Gynecologica Scandinavica
Publisher
Wiley
Published
2005-02-16
Volume
84
Issue
3
Pages
238-247
ISSN
  • 0001-6349 (ISSN-L)
  • 1600-0412
DOI
10.1111/j.0001-6349.2005.00610.x
OpenAlex
W2156020698
Cited by
166
References
53
Citations by year
2026: 2 · 2025: 2 · 2024: 8 · 2023: 9 · 2022: 6 · 2021: 2 · 2020: 5 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 2 · 2015: 12 · 2014: 3 · 2013: 12 · 2012: 11
FWCI
5.12
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
Rigshospitalet
Topics
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
Keywords
iron supplementation, pregnancy, iron deficiency, iron deficiency anemia, ferrous fumarate, dose-response relationship, serum ferritin, hemoglobin, soluble transferrin receptor, iron status, postpartum period, maternal iron status, iron prophylaxis, anemia of prematurity
MeSH terms
Iron Deficiencies, Adult, Denmark, Dose-Response Relationship, Drug, Double-Blind Method, Female, Ferritins, Fetal Blood, Hemoglobins, Humans, Infant, Newborn, Iron, Nutritional Status, Pregnancy, Receptors, Transferrin, Prevalence, Anemia, Iron-Deficiency, Dietary Supplements, Postpartum Period

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