The impact of twice weekly versus daily iron supplementation on cord blood hemoglobin and ferritin levels: a randomized clinical trial

To compare the effect of twice weekly and daily iron supplementation during pregnancy on fetal hematologic and anthropometric indices. A randomized clinical trial was conducted at Imam Hospital prenatal clinic, sari, Iran. Two hundred and eighty one nonanemic pregnant women aged 18-35, with singleton pregnancy and normal BMI were randomly assigned to either daily (one 60 mg ferrous sulfate tablet per day) or weekly (one 60 mg ferrous sulfate tablet on Monday and Thursday) iron supplementation regimens from week 20 till delivery. Mothers were followed and Cord blood was sampled (130 samples from daily group and 151 samples from weekly group) to measure the Hemoglobin (Hb) and Ferritin concentrations. Data were analyzed using Student’s t test and chi-square test. Two groups were not significantly different in terms of mother's age, education, job, number of term pregnancies, baseline BMI and Hb levels. The mean for Cord blood Hb concentration in daily and weekly groups were 14.65 (±0.18) and 14.42 (±0.16) g/l respectively. Mean cord Ferritin concentrations were 158.34 (±24.6) for daily and 148 (±14.15) µg/l for weekly group. Hb and Ferritin levels did not differ between two groups significantly (P=0.06 and P=0.51 correspondingly). Birth weight and length in daily group were higher (P<0.0001 and P<0.007 in order of reference). Since birth anthropometric parameters were more desirable in daily schedule, and knowing the influence of birth weight on neonate future health and survival, we suggest that twice weekly iron supplementation held in reserve for pregnant mothers who cannot tolerate the gastrointestinal side effects of daily iron intake.