Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Prenatal iron supplementation in rural Vietnam

Abstract

Objective:

To assess the potential impact of a national iron supplementation programme in rural Vietnam.

Methods:

The study included questionnaires, focus group discussions of pregnant women and key informant interviews, together with measurements of haemoglobin (Hb) and a stool examination for soil-transmitted helminths.

Results:

Iron supplementation significantly increased Hb concentration among participants in the second and third trimesters by 0.4 and 0.7 g/dl, respectively (P=0.017 and P<0.001). The risk of anaemia (Hb <10.0 g/dl) was increased significantly by hookworm infestation (P=0.041) and in summer season (P=0.001) and was decreased significantly by taking iron tablets (P=0.041).

Conclusions:

The results of this study show that an iron supplementation programme is beneficial as a part of a comprehensive anaemia programme for pregnant women in these communities. These results will be useful for developing improved iron-deficiency anaemia control programs for pregnant women.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • Abel R, Rajaratnam J, Kalaimani A, Kirubakaran S (2000). Can iron status be improved in each of the three trimesters? A community-based study. Eur J Clin Nutr 54, 490–493.

    Article  CAS  Google Scholar 

  • Afsana K, Shiga K, Ishizuka S, Hara H (2004). Reducing effect of ingesting tannic acid on the absorption of iron, but not of zinc, copper and manganese by rats. Biosci Biotechnol Biochem 68, 584–592.

    Article  CAS  Google Scholar 

  • Aikawa R, Jimba M, Khan NC, Zhao Y, Binns CW, Lee MK (2006a). Why do adult women in Vietnam take iron tablets? BMC Public Health 6, 144.

    Article  Google Scholar 

  • Aikawa R, Khan NC, Sasaki S, Binns CW (2006b). Risk factors for iron-deficiency anaemia among pregnant women living in rural Vietnam. Public Health Nutr 9, 443–448.

    Article  Google Scholar 

  • Allen HL, Casterline-Sabel J (2000). Prevalence and Causes of Nutritional Anemia. In: Ramakrishnan U (ed). Nutritional Anemia. CRC press: Florida, pp 7–22.

    Google Scholar 

  • Allen L, Gillespie S (2001). What Works? A Review of the Efficacy and Effectiveness of Nutrition Interventions. Nutrition Policy Paper Series Vol. 19, Asian Development Bank (ADB) No.5. United Nation administration committee coordination, sub-committee on nutrition/ADB: Geneva/ Manila. pp 43–54.

    Google Scholar 

  • Atukorala TM, de Silva LD, Dechering WH, Dassenaeike TS, Perera RS (1994). Evaluation of effectiveness of iron-folate supplementation and anthelminthic therapy against anemia in pregnancy – a study in the plantation sector of Sri Lanka. Am J Clin Nutr 60, 286–292.

    Article  CAS  Google Scholar 

  • Bach Kristensen M, Hels O, Morberg C, Marving J, Bugel S, Tetens I (2005). Pork meat increases iron absorption from a 5-day fully controlled diet when compared to a vegetarian diet with similar vitamin C and phytic acid content. Br J Nutr 94, 78–83.

    Article  Google Scholar 

  • Beard J (1995). One person's view of iron deficiency, development, and cognitive function. Am J Clin Nutr 62, 709–710.

    Article  CAS  Google Scholar 

  • Bondevik GT, Eskeland B, Ulvik RJ, Ulstein M, Lie RT, Schneede J et al. (2000). Anaemia in pregnancy: possible causes and risk factors in Nepali women. Eur J Clin Nutr 54, 3–8.

    Article  CAS  Google Scholar 

  • Brune M, Rossander L, Hallberg L (1989). Iron absorption and phenolic compounds: importance of different phenolic structures. Eur Clin Nutr 43, 547–557.

    CAS  Google Scholar 

  • Christian P, Khatry SK, West Jr KP (2004). Antenatal anthelmintic treatment, birthweight, and infant survival in rural Nepal. Lancet 364, 981–983.

    Article  CAS  Google Scholar 

  • Department of Culture and Information (1999). Joint Report of the Government-Donor-NGO Working Group. Vietnam development report 2000. Attacking poverty. Department of Culture and Information: Hanoi.

  • Earl R, Wateki CE (1993). Iron deficient anemia, recommendation guidelines for the prevention, detection and management among US children and women of childbearing age. National Academy Press: Washington, DC.

    Google Scholar 

  • English RM, Badcock JC, Giay T, Ngu T, Waters AM, Bennett SA (1997). Effect of nutrition improvement project on morbidity from infectious diseases in preschool children in Vietnam: comparison with control commune. BMJ 315, 1122–1125.

    Article  CAS  Google Scholar 

  • Galloway R, McGuire J (1994). Determinants of compliance with iron supplementation: supplies, side effects, or psychology? Soc Sci Med 39, 381–390.

    Article  CAS  Google Scholar 

  • General Statistics Office of Vietnam (2007): http://www.gso.gov.vn/default.aspx?tabid=503&ItemID=1841accessed on January 26, 2007.

  • Hallberg L (1985). The role of vitamin C in improving the critical iron balance situation in women. Int J Vitam Nutr Res Suppl 27, S177–S187.

    Google Scholar 

  • Hallberg L (1987). Wheat fiber, phytates and iron absorption. Scand J Gastroenterol Suppl 129, S73–S79.

    Article  Google Scholar 

  • Hoang TQ (2001). National Nutrition Strategy 2001–2010. Medical Publishing House: Hanoi.

    Google Scholar 

  • Johns WL, Lewis SM (1989). Primary health screening by haemoglobinometry in a tropical community. Bull World Health Organ 67, 627–633.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Khoi HH (2001). Report on Vietnam national anemia survey, 2000. National Institute of Nutrition: Hanoi.

  • Mason JB, Lotfi M, Dalmiya N, Sethuraman K, Deitchler M, Scott G et al. (2001). The micronutrient report, current progress and trends in the control of Vitamin A, iodine and iron deficiencies. Micronutrient Initiative: Ottawa.

  • Musaiger AO (2002). Iron deficiency anemia among children and pregnant women in the Arab Gulf countries: the need for action. Nutr Health 16, 161–171.

    Article  Google Scholar 

  • National Committee for Population, Family and Children Population and Family Health Project (2003). Demographic Health Survey 2002. General Statistical Office and ORC Macro: Hanoi.

  • National Institute of Nutrition (1995). Report of the national anemia and nutrition risk factor survey. National Institute of Nutrition: Hanoi.

  • Pawlowski ZS, Schad GA, Stott GJ (2002). Hookworm infection and anemia. Approaches to prevention and control. World Health Organization: Geneva.

    Google Scholar 

  • Plasqui G, Westerterp KR (2004). Seasonal variation in total energy expenditure and physical activity in Dutch young adults. Obes Res 12, 688–694.

    Article  Google Scholar 

  • Preziosi P, Prual A, Galan P, Daouda H, Boureima H, Hercberg S (1997). Effect of iron supplementation on the iron status of pregnant women: consequences for newborns. Am J Clin Nutr 66, 1178–1182.

    Article  CAS  Google Scholar 

  • Roodenburg AJ (1995). Iron supplementation during pregnancy. Eur J Obstet Gynecol Reprod Biol 61, 65–71.

    Article  CAS  Google Scholar 

  • Sloan NL, Jordan E, Winikoff B (2002). Effects of iron supplementation on maternal hematologic status in pregnancy. Am J Public Health 92, 288–293.

    Article  Google Scholar 

  • Stoltzfus R, Dreyfuss M (1998). Guidelines for the Use of iron Supplements to Prevent and Treat Iron Deficiency Anemia. ILSI Press: Washington DC.

    Google Scholar 

  • UNICEF/UNU/WHO (2001). Iron Deficiency Anaemia: Assessment, Prevention and Control. A Guide for Programme Managers. World Health Organization: Geneva.

  • Verhoeff FH, Brabin BJ, Chimsuku L, Kazembe P, Broadhead RL (1999). An analysis of the determinants of anaemia in pregnant women in rural Malawi-a basis for action. Ann Trop Med Parasitol 93, 119–133.

    Article  CAS  Google Scholar 

  • WHO (1992). The Prevalence of Anaemia in Women: A Tabulation of Available Information. WHO/NUT/MCM/92.2. World Health Organization: Geneva.

  • Yip R (1994). Iron deficiency: contemporary scientific issues and international programmatic approaches. J Nutr 124 (Suppl 8), S1479–S1490.

    Article  Google Scholar 

Download references

Acknowledgements

This study was financially supported by the Japanese Cooperation Agency (JICA) from February 2002 to February 2004. We acknowledge the assistance of people who worked in the field survey. We thank all the participants of this survey and the staff of commune health centres, district health service of Yen Thanh district, preventive medical centre of Nghe An province, Dr Thuy Hoa and Dr Nyguen Lan in National Institute of Nutrition for their assistance in the field survey.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C W Binns.

Additional information

Contributors: RA is a principle investigator, MJ is a co-investigator, KCN is a co-investigator in Vietnam, and CWB participated in the design of the study, statistic analysis and manuscript review. All the authors read and approved the final manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aikawa, R., Jimba, M., Nguen, K. et al. Prenatal iron supplementation in rural Vietnam. Eur J Clin Nutr 62, 946–952 (2008). https://doi.org/10.1038/sj.ejcn.1602812

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1602812

Keywords

Search

Quick links