Tags

Type your tag names separated by a space and hit enter

Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates.
J Nutr. 2015 Aug; 145(8):1916-23.JN

Abstract

BACKGROUND

Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status.

OBJECTIVE

The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status.

METHODS

Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at ≤20 wk gestation, aged ≥18 y, and with hemoglobin ≥100 g/L were randomly assigned 1:1 to receive daily iron (300 mg ferrous sulfate) or placebo + 0.40 mg folate from enrollment to birth. Iron status was assessed in maternal venous blood (at enrollment and at or near term) and cord blood. Primary outcomes were as follows: 1) maternal iron deficiency (ID) defined in 2 ways as serum ferritin (SF) <15 μg/L and body iron (BI) <0 mg/kg; 2) maternal ID anemia [ID + anemia (IDA); hemoglobin <110 g/L]; and 3) neonatal ID (cord blood ferritin <75 μg/L or zinc protoporphyrin/heme >118 μmol/mol).

RESULTS

A total of 2371 women were randomly assigned, with outcomes for 1632 women or neonates (809 placebo/folate, 823 iron/folate; 1579 mother-newborn pairs, 37 mothers, 16 neonates). Most infants (97%) were born at term. At or near term, maternal hemoglobin was significantly higher (+5.56 g/L) for iron vs. placebo groups. Anemia risk was reduced (RR: 0.53; 95% CI: 0.43, 0.66), as were risks of ID (RR: 0.74; 95% CI: 0.69, 0.79 by SF; RR: 0.65; 95% CI: 0.59, 0.71 by BI) and IDA (RR: 0.49; 95% CI: 0.38, 0.62 by SF; RR: 0.51; 95% CI: 0.40, 0.65 by BI). Most women still had ID (66.8% by SF, 54.7% by BI). Adverse effects, all minor, were similar by group. There were no differences in cord blood iron measures; >45% of neonates in each group had ID. However, dose-response analyses showed higher cord SF with more maternal iron capsules reported being consumed (β per 10 capsules = 2.60, P < 0.05).

CONCLUSIONS

Prenatal iron supplementation reduced anemia, ID, and IDA in pregnant women in rural China, but most women and >45% of neonates had ID, regardless of supplementation. This trial was registered at clinicaltrials.gov as NCT02221752.

Authors+Show Affiliations

Peking University First Hospital, Beijing, China;Peking University First Hospital, Beijing, China;Peking University First Hospital, Beijing, China;Peking University First Hospital, Beijing, China;Center for Human Growth and Development and.Center for Human Growth and Development and.Center for Human Growth and Development and.Department of Pediatrics, University of Minnesota, Minneapolis, MN.Peking University First Hospital, Beijing, China;Center for Human Growth and Development and.Peking University First Hospital, Beijing, China;Center for Human Growth and Development and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI; and blozoff@umich.edu.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26063068

Citation

Zhao, Gengli, et al. "Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates." The Journal of Nutrition, vol. 145, no. 8, 2015, pp. 1916-23.
Zhao G, Xu G, Zhou M, et al. Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates. J Nutr. 2015;145(8):1916-23.
Zhao, G., Xu, G., Zhou, M., Jiang, Y., Richards, B., Clark, K. M., Kaciroti, N., Georgieff, M. K., Zhang, Z., Tardif, T., Li, M., & Lozoff, B. (2015). Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates. The Journal of Nutrition, 145(8), 1916-23. https://doi.org/10.3945/jn.114.208678
Zhao G, et al. Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates. J Nutr. 2015;145(8):1916-23. PubMed PMID: 26063068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates. AU - Zhao,Gengli, AU - Xu,Guobin, AU - Zhou,Min, AU - Jiang,Yaping, AU - Richards,Blair, AU - Clark,Katy M, AU - Kaciroti,Niko, AU - Georgieff,Michael K, AU - Zhang,Zhixiang, AU - Tardif,Twila, AU - Li,Ming, AU - Lozoff,Betsy, Y1 - 2015/06/10/ PY - 2014/12/12/received PY - 2015/05/26/accepted PY - 2015/6/12/entrez PY - 2015/6/13/pubmed PY - 2015/10/28/medline KW - iron deficiency KW - iron deficiency anemia KW - iron supplementation KW - neonates KW - pregnant women KW - randomized clinical trial SP - 1916 EP - 23 JF - The Journal of nutrition JO - J Nutr VL - 145 IS - 8 N2 - BACKGROUND: Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status. OBJECTIVE: The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status. METHODS: Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at ≤20 wk gestation, aged ≥18 y, and with hemoglobin ≥100 g/L were randomly assigned 1:1 to receive daily iron (300 mg ferrous sulfate) or placebo + 0.40 mg folate from enrollment to birth. Iron status was assessed in maternal venous blood (at enrollment and at or near term) and cord blood. Primary outcomes were as follows: 1) maternal iron deficiency (ID) defined in 2 ways as serum ferritin (SF) <15 μg/L and body iron (BI) <0 mg/kg; 2) maternal ID anemia [ID + anemia (IDA); hemoglobin <110 g/L]; and 3) neonatal ID (cord blood ferritin <75 μg/L or zinc protoporphyrin/heme >118 μmol/mol). RESULTS: A total of 2371 women were randomly assigned, with outcomes for 1632 women or neonates (809 placebo/folate, 823 iron/folate; 1579 mother-newborn pairs, 37 mothers, 16 neonates). Most infants (97%) were born at term. At or near term, maternal hemoglobin was significantly higher (+5.56 g/L) for iron vs. placebo groups. Anemia risk was reduced (RR: 0.53; 95% CI: 0.43, 0.66), as were risks of ID (RR: 0.74; 95% CI: 0.69, 0.79 by SF; RR: 0.65; 95% CI: 0.59, 0.71 by BI) and IDA (RR: 0.49; 95% CI: 0.38, 0.62 by SF; RR: 0.51; 95% CI: 0.40, 0.65 by BI). Most women still had ID (66.8% by SF, 54.7% by BI). Adverse effects, all minor, were similar by group. There were no differences in cord blood iron measures; >45% of neonates in each group had ID. However, dose-response analyses showed higher cord SF with more maternal iron capsules reported being consumed (β per 10 capsules = 2.60, P < 0.05). CONCLUSIONS: Prenatal iron supplementation reduced anemia, ID, and IDA in pregnant women in rural China, but most women and >45% of neonates had ID, regardless of supplementation. This trial was registered at clinicaltrials.gov as NCT02221752. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/26063068/Prenatal_Iron_Supplementation_Reduces_Maternal_Anemia_Iron_Deficiency_and_Iron_Deficiency_Anemia_in_a_Randomized_Clinical_Trial_in_Rural_China_but_Iron_Deficiency_Remains_Widespread_in_Mothers_and_Neonates_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.114.208678 DB - PRIME DP - Unbound Medicine ER -