HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Data Supplement Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (16) Citing Articles via Google Scholar Google Scholar Articles by Sloan, N. L. Articles by Winikoff, B. Search for Related Content PubMed PubMed Citation Articles by Sloan, N. L. Articles by Winikoff, B. Related Collections Pregnancy Nutrition/Food

Nancy L. Sloan, DrPH, Elizabeth Jordan, MD, PhD and Beverly Winikoff, MD, MPH

Nancy L. Sloan and Beverly Winikoff are with the Population Council, New York, NY. Elizabeth Jordan is with Bristol Myers Squibb, Princeton, NJ.

Correspondence: Requests for reprints should be sent to Nancy L. Sloan, DrPH, Population Council, 1 Dag Hammarskjold Plaza, New York, NY 10017 (e-mail: nsloan{at}popcouncil.org).

Objectives. Prenatal iron supplementation has been the standard recommendation for reducing maternal anemia in developing countries for the past 30 years. This article reviews the efficacy of iron supplementation on hemoglobin levels in pregnant women in developing countries.

Methods. Data from randomized controlled trials published between 1966 and 1998 were pooled. Meta-analyses of the relative change in maternal hemoglobin associated with iron supplementation were stratified by initial hemoglobin levels, duration of supplementation, and daily gestational supplement dose and supplementation with other nutrients.

Results. Iron supplementation raises hemoglobin levels. Its effects are dose dependent and are related to initial hematologic status. The extent to which iron supplementation can reduce maternal anemia is unclear.

Conclusions. The extent to which maternal hemoglobin levels can be increased by recommended prenatal supplementation is limited and has uncertain physiological benefits. Other approaches, including food fortification and prevention and treatment of other causes of anemia, require methodologically rigorous evaluation to find effective answers to this global problem.

This article has been cited by other articles:

				W. W Fawzi, G. I Msamanga, R. Kupka, D. Spiegelman, E. Villamor, F. Mugusi, R. Wei, and D. Hunter Multivitamin supplementation improves hematologic status in HIV-infected women and their children in Tanzania Am. J. Clinical Nutrition, May 1, 2007; 85(5): 1335 - 1343. [Abstract] [Full Text] [PDF]

				P. Menon, M. T. Ruel, C. U. Loechl, M. Arimond, J.-P. Habicht, G. Pelto, and L. Michaud Micronutrient Sprinkles Reduce Anemia among 9- to 24-Mo-Old Children When Delivered through an Integrated Health and Nutrition Program in Rural Haiti J. Nutr., April 1, 2007; 137(4): 1023 - 1030. [Abstract] [Full Text] [PDF]

				T. O Scholl Iron status during pregnancy: setting the stage for mother and infant Am. J. Clinical Nutrition, May 1, 2005; 81(5): 1218S - 1222S. [Abstract] [Full Text] [PDF]

				W. W Fawzi, E. Villamor, G. I Msamanga, G. Antelman, S. Aboud, W. Urassa, and D. Hunter Trial of zinc supplements in relation to pregnancy outcomes, hematologic indicators, and T cell counts among HIV-1-infected women in Tanzania Am. J. Clinical Nutrition, January 1, 2005; 81(1): 161 - 167. [Abstract] [Full Text] [PDF]

				R. Baltussen, C. Knai, and M. Sharan Iron Fortification and Iron Supplementation are Cost-Effective Interventions to Reduce Iron Deficiency in Four Subregions of the World J. Nutr., October 1, 2004; 134(10): 2678 - 2684. [Abstract] [Full Text] [PDF]

				W. C. Hawkes Association of Glutathione Peroxidase Activity with Insulin Resistance and Dietary Fat Intake during Normal Pregnancy J. Clin. Endocrinol. Metab., September 1, 2004; 89(9): 4772 - 4773. [Full Text] [PDF]

				K. L. Delucchi Sample Size Estimation in Research With Dependent Measures and Dichotomous Outcomes Am J Public Health, March 1, 2004; 94(3): 372 - 377. [Abstract] [Full Text] [PDF]

				P. Christian, J. Shrestha, S. C. LeClerq, S. K. Khatry, T. Jiang, T. Wagner, J. Katz, and K. P. West Jr Supplementation with Micronutrients in Addition to Iron and Folic Acid Does Not Further Improve the Hematologic Status of Pregnant Women in Rural Nepal J. Nutr., November 1, 2003; 133(11): 3492 - 3498. [Abstract] [Full Text] [PDF]

				D. Makola, D. M. Ash, S. R. Tatala, M. C. Latham, G. Ndossi, and H. Mehansho A Micronutrient-Fortified Beverage Prevents Iron Deficiency, Reduces Anemia and Improves the Hemoglobin Concentration of Pregnant Tanzanian Women J. Nutr., May 1, 2003; 133(5): 1339 - 1346. [Abstract] [Full Text] [PDF]

				P. R. Meier, H. J. Nickerson, K. A. Olson, R. L. Berg, and J. A. Meyer Prevention of Iron Deficiency Anemia in Adolescent and Adult Pregnancies Clin. Med. Res., January 1, 2003; 1(1): 29 - 36. [Abstract] [Full Text] [PDF]