Guidelines for iron supplementation in pregnancy: compliance among 431 parous Scandinavian women

Eur J Clin Pharmacol. 2003 Jun;59(2):163-8. doi: 10.1007/s00228-003-0599-x. Epub 2003 May 7.


Objective: The need for iron in pregnancy is rarely met by dietary food intake alone. Therefore, guidelines on iron supplementation have been developed to ensure optimal maternal and foetal iron provision. Today, the World Health Organization recommends iron supplementation during the second half of pregnancy. Our aim was to study compliance to these guidelines among 431 parous Scandinavian women. In addition, the association between maternal socio-demographic and lifestyle factors, maternal haemoglobin (Hb) values and non-compliance was assessed.

Methods: The women were interviewed about iron use at gestational weeks 25, 33 and 37 at the three Scandinavian study sites, Trondheim, Bergen and Uppsala.

Results: In all, 27% of the women used iron supplements continuously during the second half of pregnancy, hence complying with the guidelines. Further, 41% of the women reported periodical and 32% no use of iron supplementation during the second half of pregnancy. In the multivariable analyses, high Hb-concentration, living in Uppsala [OR: 3.1 (1.6-6.0)] or Bergen [OR: 4.7 (2.4-9.3)] as opposed to Trondheim, and smoking during pregnancy [OR: 2.0 (1.1-3.5)] were associated with non-compliance to guidelines.

Conclusion: We conclude that maternal Hb values, demographic factors and smoking during pregnancy are among the factors associated with non-compliance to guidelines on iron supplementation during pregnancy.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Dietary Supplements*
  • Female
  • Hemoglobins / analysis
  • Humans
  • Iron / administration & dosage*
  • Iron / therapeutic use
  • Patient Compliance*
  • Practice Guidelines as Topic
  • Pregnancy Trimesters
  • Pregnancy*
  • Scandinavian and Nordic Countries
  • Smoking


  • Hemoglobins
  • Iron