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Date of Award

Spring 2021

Degree Name

Master of Science in Health Education

Department

Physician Assistant; College of Health Sciences

First Advisor

Liz Masten

Abstract

Abstract:

Introduction:

Pregnant women are usually prophylactically treated with iron supplements worldwide. National recommendations are 100 mg of elemental iron and 0.5 mg of folic acid for at least 100 days during gestation.1 Prophylaxis of both iron and folic acid during pregnancy is recommended because becoming deficient in these nutrients could have detrimental effects on the fetus. In pregnant women (³18 adults) (P), does iron supplementation (I) (versus the placebo)(C), reduce the risk of low birth weight neonates (O)? The study will look at multiple different controlled trials and the most recent data on the use of iron supplementation and the current protocol for taking additional non-dietary iron during pregnancy.

Methods:

A literature search was conducted in November 2019 using PubMed and EBSCO databases. A total of seven articles consisting of randomized control trials, prospective cohort studies, and cross-sectional surveys were selected for review. The design and results of the studies were examined and compared.

Results:

The evidence collected in some of the studies showed a statistically significant difference in birth weight between the participant groups and some of the studies did not show a statistical difference. Although there is strong evidence supporting the supplementation of iron in pregnant women, a stricter and more pointed study must be conducted to determine its direct effect on birth weight. Larger, more diverse sample groups, a simultaneous placebo group, and more double-blinded control trials should be considered to further develop more efficacious studies and improve the strength of the results.

Discussion:

Although, in many of the studies a statistical difference was not found, specifically, between birth weight and iron supplementation, there were often other influencing factors and birth outcomes that were measured. Three of the studies showed statistically significant differences in neonate birth weight with iron and/or folate supplementation. Other studies showed significant differences with other forms of supplementation and other maternal and delivery outcomes. There is difficulty in obtaining an accurate and specific result to this question because the studies were designed with slightly different goals and collected data on various outcomes. For a more efficacious study that answers the question of iron supplementation in pregnancy and its effect on birth weight, a study comparing iron supplements, solely, to a placebo simultaneously, should be designed.

Conclusion:

There is sufficient data supporting the use, benefits, and safety of the current recommendation for iron prophylaxis during pregnancy. Positive findings in support of the current recommendations were found in most of the studies although no comparison to a standard was established. Healthcare providers should continue current practice in advising pregnant patients to consume the recommended amount of iron, along with other micronutrients to maintain a healthy pregnancy and reduce the risk of adverse maternal and fetal outcomes.

Additional Files

PICO poster andrea.pptx (2254 kB)

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In Pregnant Women, Does Iron Supplementation Reduce the Risk of Low Birth Weight Neonates?

Abstract:

Introduction:

Pregnant women are usually prophylactically treated with iron supplements worldwide. National recommendations are 100 mg of elemental iron and 0.5 mg of folic acid for at least 100 days during gestation.1 Prophylaxis of both iron and folic acid during pregnancy is recommended because becoming deficient in these nutrients could have detrimental effects on the fetus. In pregnant women (³18 adults) (P), does iron supplementation (I) (versus the placebo)(C), reduce the risk of low birth weight neonates (O)? The study will look at multiple different controlled trials and the most recent data on the use of iron supplementation and the current protocol for taking additional non-dietary iron during pregnancy.

Methods:

A literature search was conducted in November 2019 using PubMed and EBSCO databases. A total of seven articles consisting of randomized control trials, prospective cohort studies, and cross-sectional surveys were selected for review. The design and results of the studies were examined and compared.

Results:

The evidence collected in some of the studies showed a statistically significant difference in birth weight between the participant groups and some of the studies did not show a statistical difference. Although there is strong evidence supporting the supplementation of iron in pregnant women, a stricter and more pointed study must be conducted to determine its direct effect on birth weight. Larger, more diverse sample groups, a simultaneous placebo group, and more double-blinded control trials should be considered to further develop more efficacious studies and improve the strength of the results.

Discussion:

Although, in many of the studies a statistical difference was not found, specifically, between birth weight and iron supplementation, there were often other influencing factors and birth outcomes that were measured. Three of the studies showed statistically significant differences in neonate birth weight with iron and/or folate supplementation. Other studies showed significant differences with other forms of supplementation and other maternal and delivery outcomes. There is difficulty in obtaining an accurate and specific result to this question because the studies were designed with slightly different goals and collected data on various outcomes. For a more efficacious study that answers the question of iron supplementation in pregnancy and its effect on birth weight, a study comparing iron supplements, solely, to a placebo simultaneously, should be designed.

Conclusion:

There is sufficient data supporting the use, benefits, and safety of the current recommendation for iron prophylaxis during pregnancy. Positive findings in support of the current recommendations were found in most of the studies although no comparison to a standard was established. Healthcare providers should continue current practice in advising pregnant patients to consume the recommended amount of iron, along with other micronutrients to maintain a healthy pregnancy and reduce the risk of adverse maternal and fetal outcomes.