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Maternal and pediatric nutrition

Association of oral iron supplementation with birth outcomes in non-anaemic South Indian pregnant women

European Journal of Clinical Nutrition volume 69, pages 609–613 (2015)Cite this article

Subjects

Abstract

Background/Objectives:

Iron in high doses or when given to non-anaemic women may have adverse effects on pregnancy outcomes. This study aimed to estimate the supplemental iron intake in non-anaemic pregnant women attending an urban antenatal care setting in South India and examine the association of supplemental iron intake with birth outcomes.

Subjects/Methods:

A cohort of 1196 non-anaemic pregnant women was studied. Daily supplemental iron intake was calculated as total supplemental iron consumed (mg) during pregnancy divided by the total number of days the supplement was recommended. Association of tertiles of supplemental iron intake with term low birth weight (tLBW), preterm delivery and small for gestational age (SGA) was examined using log-binomial regression, adjusting for maternal age, height, body mass index at recruitment, parity, education and type of delivery.

Results:

Mean haemoglobin in trimester 1 was 12.4±0.9 g/dl and mean supplemental iron intake was 37.7±4.0 mg/day. Women in the highest tertile (>39.2 mg/day) of supplemental iron intake had an increased risk of tLBW as compared with the lowest tertile (⩽36.6 mg/day) (adjusted risk ratio: 1.89; 95% confidence interval: 1.26, 2.83). Although supplemental iron intake was negatively correlated with gestational age (r=−0.20, P<0.001) and birth weight (r=−0.07, P=0.011), there was no association between preterm delivery or SGA and supplemental iron intake.

Conclusions:

It appears that iron supplementation in non-anaemic pregnant women may not be beneficial, as we have observed the adverse effects with a prescribed dose of 45 mg/day. This may warrant the consideration of an individualized approach for antenatal iron supplementation, especially in non-anaemic women.

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Acknowledgements

We greatly appreciate the assistance of Nancy Nanditha M in the collection and entry of data. We thank the women and their infants who participated in this study and the doctors and nurses who made this study possible. LS, PEM, PD, TT and AVK took part in conceptualizing the study, analyzing data and writing the manuscript. PD and AT were involved in data collection. CD, RB and CMM were involved in analyzing data and writing the manuscript. AVK stands as guarantor of the study.

Registered at Clinical Trials Registry-India (www.ctri.nic.in) REF/2013/07/005342.

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Authors and Affiliations

  1. St John’s Medical College, Bangalore, India

    L Shastri & P E Mishra

  2. Division of Nutrition, St. John’s Research Institute, Bangalore, India

    P Dwarkanath & A V Kurpad

  3. Division of Epidemiology and Biostatistics, St John’s Research Institute, Bangalore, India

    T Thomas

  4. Division of GI/Nutrition, Boston Children's Hospital, Boston, MA, USA

    C Duggan & C M McDonald

  5. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    R Bosch

  6. Department of Obstetrics and Gynaecology, St. John’s Medical College Hospital, Bangalore, India

    A Thomas

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  1. L Shastri
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  9. A V Kurpad
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Correspondence to A V Kurpad.

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Shastri, L., Mishra, P., Dwarkanath, P. et al. Association of oral iron supplementation with birth outcomes in non-anaemic South Indian pregnant women. Eur J Clin Nutr 69, 609–613 (2015). https://doi.org/10.1038/ejcn.2014.248

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  • DOI: https://doi.org/10.1038/ejcn.2014.248

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