Routine Iron Supplementation and Anaemia by Third Trimester in a Nigerian Hospital

Abstract

BACKGROUND: Anaemia in pregnancy is associated with adverse maternal and fetal outcome.  Unfortunately, in developing countries its prevalence has continued to rise. To improve the situation, iron  supplement is routinely prescribed during pregnancy. We therefore examine the impact of the intervention as being currently practised in our clinical setting.
METHODS: In total, 255 prenatal clinic attendees who had more than 8 weeks of prescribed iron  supplements were sampled. Data was obtained on their socio-demographic features, haemoglobin concentration at booking, compliance with iron supplements and third trimester haemoglobin value.
RESULTS: Observed iron supplementation compliance rate was 184(72.2%). There was a significant  drop in mean haemoglobin (Hb) concentration between the two time points (booking Hb: 32.56±2.99;  third trimester Hb: 31.67±3.01; mean diff: 0.89±3.04; t = 4.673; 95% CI= 0.52-1.27; p= <0.001).  Anaemia increased from 132(51.8%) to 150(58.8%) by the third trimester. Increase in anaemia occurred  in both iron-compliant and non-compliant groups. Non-compliance however had higher odds of predicting anaemia by the third trimester (OR: 1.83; 95% CI: 1.03-3.26; p: 0.04).
CONCLUSION: Although iron supplementation is still a good intervention in developing countries, it is  not sufficient to reduce overall prevalence of anaemia by the third trimester. There is a need to look  beyond the approach and reinforce the importance of better feeding practices, food fortification and  reduced frequency of pregnancies.

KEYWORDS: Anaemia, pregnancy, iron supplementation, outcome, food fortification