期刊
JOURNAL OF NUTRITION
卷 145, 期 8, 页码 1916-1923出版社
OXFORD UNIV PRESS
DOI: 10.3945/jn.114.208678
关键词
pregnant women; neonates; iron supplementation; iron deficiency; iron deficiency anemia; randomized clinical trial
资金
- NIH
Background: Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status. Objective: The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status. Methods: Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at <= 20 wk gestation, aged >= 18 y, and with hemoglobin >= 100 g/L were randomly assigned '1 :1 to receive daily iron (300 mg ferrous sulfate) or placebo + 0.40 mg folate from enrollment to birth. Iron status was assessed in maternal venous blood (at enrollment and at or near term) and cord blood. Primary outcomes were as follows: 1) maternal iron deficiency (ID) defined in 2 ways as serum ferritin (SF) <15 mu g/L and body iron (BI) <0 mg/kg; 2) maternal ID anemia [ID + anemia (IDA); hemoglobin <110 g/L]; and 3) neonatal ID (cord blood ferritin <75 mu g/L or zinc protoporphyrin/heme >118 mu mol/mol). Results: A total of 2371 women were randomly assigned, with outcomes for 1632 women or neonates 1809 placebo/folate, 823 iron/folate; 1579 mother-newborn pairs, 37 mothers, 16 neonates). Most infants (97%) were born at term. At or near term, maternal hemoglobin was significantly higher (+5.56 g/L) for iron vs. placebo groups. Anemia risk was reduced (RR: 0.53; 95% Cl: 0.43, 0.66), as were risks of ID (RR: 0.74; 95% Cl: 0.69, 0.79 by SF; RR: 0.65; 95% CI: 0.59, 0.71 by BI) and IDA (RR: 0.49; 95% CI: 0.38, 0.62 by SF; RR: 0.51; 95% Cl: 0.40, 0.65 by BI). Most women still had ID (66.8% by SF, 54.7% by BD. Adverse effects, all minor, were similar by group. There were no differences in cord blood iron measures; >45% of neonates in each group had ID. However, dose-response analyses showed higher cord SF with more maternal iron capsules reported being consumed (beta per 10 capsules = 2:60, P < 0.05). Conclusions: Prenatal iron supplementation reduced anemia, ID, and IDA in pregnant women in rurql ghina, but most women and >45% of neonates had ID, regardless of supplementation. This trial was registered at clinicaltnals.gov as NCT02221752.
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