Universal iron supplementation: a simple and effective strategy to reduce anaemia among low-income, postpartum women

Public Health Nutr. 2012 Mar;15(3):546-53. doi: 10.1017/S1368980011001261. Epub 2011 Jun 23.

Abstract

Objective: To reduce prevalence of anaemia in low-income postpartum women.

Design: A randomised, non-blind clinical trial was conducted among 959 low-income, postpartum women in eleven clinics in Mississippi. The clinics were randomised to one of three treatment groups: (i) selective anaemia screening of high-risk women as recommended currently (control); (ii) universal anaemia screening and treatment of anaemic women (group I); and (iii) universal Fe supplementation of 65 mg/d for two months to all low-income women (group II). All study participants within each clinic received the same treatment. Women were followed up at 6 months after delivery. Hb was measured at baseline and at follow-up. The primary outcome variable was the proportion of women with anaemia after treatment.

Setting: Eleven health clinics in Mississippi.

Subjects: Low-income, postpartum women.

Results: Baseline characteristics of the three study groups were compared using one-way ANOVA and an appropriate post hoc test for continuous variables and the χ2 test for categorical variables. Fifty-two per cent of postpartum women were anaemic (Hb < 12·0 g/dl) and the rate decreased to 33 % at 6 months after the intervention. Group II women, who received universal Fe supplementation, improved their Hb status significantly (P < 0·001) at 6 months postpartum compared with the other groups. Prevalence of anaemia was also significantly lower among group II women (22·5 %) compared with controls (34 %) and group I women (43 %; P < 0·001).

Conclusions: A universal Fe supplementation strategy was effective in reducing the prevalence of anaemia among low-income postpartum women.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Anemia, Iron-Deficiency / diagnosis
  • Anemia, Iron-Deficiency / epidemiology
  • Anemia, Iron-Deficiency / prevention & control*
  • Chi-Square Distribution
  • Dietary Supplements*
  • Female
  • Follow-Up Studies
  • Hemoglobins / metabolism
  • Humans
  • Iron / therapeutic use*
  • Mass Screening
  • Mississippi / epidemiology
  • Postpartum Period*
  • Poverty*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Prevalence
  • Trace Elements / therapeutic use*
  • Young Adult

Substances

  • Hemoglobins
  • Trace Elements
  • Iron