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Epidemiology

Prenatal iron containing supplements provided to Chinese women with no or mild anemia had no effect on hemoglobin concentration in post-partum women or their infants at 6 and 12 months of age

European Journal of Clinical Nutrition volume 73, pages 1473–1479 (2019)Cite this article

Subjects

Abstract

Background

Although prenatal iron-containing supplements have been associated with lower anemia prevalence in later pregnancy, few trials have examined the effect of supplements on the anemia status of post-partum women and their infants.

Objective

We compared the effects of folic acid alone (FA), iron-folic acid (IFA) and multiple micronutrients (MMN) when provided to pregnant women with no or mild anemia on the hemoglobin levels of post-partum women and their infants at 6 and 12 months of age. We also examined the potential modifying effect of maternal hemoglobin concentration at enrollment.

Methods

A double-blind randomized controlled trial was conducted in China; 18,775 nulliparous women with a hemoglobin concentration > 100 g/L were randomly assigned to receive daily FA (400 μg); IFA (FA, Fe 30 mg), or MMN (FA, Fe and 13 micronutrients) from before 20 gestational weeks until delivery.

Results

Compared with daily prenatal FA, supplementation with IFA or MMN did not affect the prevalence of anemia at 4–6 weeks post-partum (27.2%, 26.8%, and 26.3%, respectively). At 6 months of age, the anemia prevalence in infants was 6.9%, 6.7%, and 6.7%, respectively. Findings were similar at 12 months of age. Among both post-partum women and infants, findings were similar across all levels of hemoglobin at enrollment.

Conclusions

Compared to FA alone, prenatal IFA and MMN provided to women with no or mild anemia did not affect anemia in women post-partum or their infants regardless of baseline maternal hemoglobin concentration at enrollment.

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Acknowledgements

The study was supported by a cooperative agreement between Peking University Health Science Center and the Centers for Disease Control and Prevention.

Author contributions

MKS, JL, ZM designed the project; JL and HL conducted data collection; YZ and HL analyzed data or performed statistical analysis; MKS, YZ, and ZM wrote the paper. MKS, YZ, and ZM had primary responsibility for the final content. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA

    Mary K. Serdula & Zuguo Mei

  2. Peking University Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China

    Yubo Zhou, Hongtian Li & Jian-meng Liu

  3. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China

    Yubo Zhou, Hongtian Li & Jian-meng Liu

Authors
  1. Mary K. Serdula
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  2. Yubo Zhou
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  4. Jian-meng Liu
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  5. Zuguo Mei
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Corresponding author

Correspondence to Jian-meng Liu.

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The authors declare that they have no conflict of interest.

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Serdula, M.K., Zhou, Y., Li, H. et al. Prenatal iron containing supplements provided to Chinese women with no or mild anemia had no effect on hemoglobin concentration in post-partum women or their infants at 6 and 12 months of age. Eur J Clin Nutr 73, 1473–1479 (2019). https://doi.org/10.1038/s41430-018-0365-x

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  • DOI: https://doi.org/10.1038/s41430-018-0365-x

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