The effect of supplemental iron elimination on pregnancy outcome

Abstract

Objective: To assess the effect of eliminating supplemental iron on pregnancy outcome. Methodology: A clinical trial was conducted at Alzahra hospital from 2007 to 2009. Nine hundred sixty healthy women at first trimester of pregnancy with Hb>12 gr/dl and BP<140/90 mmHg were randomized into receiving daily one multivitamin+30 mg elemental iron or multivation + placebo tablet from 13 weeks of pregnancy. Iron parameters were analyzed at the 1st trimester and before delivery by using ELISA. Monthly Hb and Hct checkup was performed for placebo group and whom with Hb < 10.5 gr/dl at the end of 2nd trimester or Hb < 11 at 3rd trimester, excluded from the study. Finally 410 women in iron group and 372 in placebo group accomplished the study. Results: The mean weight gain of mothers in iron group was significantly greater than placebo group. (11.57kg vs. 11.09kg, p=0.018). Iron parameters at delivery time decreased, in two groups and were meaningful in placebo group. Neonatal complications were not significantly different between groups. The rate of preterm labor, IUGR, PROM, placental abruption, gestational diabetes and preeclampsia were not significantly different between groups except for pregnancy induced hypertension (6.7 % in iron group vs. 3.4 in placebo group, p=0.04). Conclusions: Considering iron is a possible source of producing free radicals which has ability of oxidative damage, it is recommended that in iron-replete non anemic women at beginning of pregnancy especially who are at high risk for hypertension, iron should not be prescribed until Hb falls below normal level.