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THE EFFEECTIVENESS OF WEEKLY VERSUS DAILY IRON SUPPLEMENTATION AMONG MILD ANEMIC PREGNANT WOMEN

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THE EFFEECTIVENESS OF WEEKLY VERSUS DAILY IRON SUPPLEMENTATION AMONG MILD ANEMIC PREGNANT WOMEN

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  1. A complete set of data was obtained for 35 women in the group supplemented daily and for 35 women in the group supplemented weekly. Majority (92.9%) of the participants were Malays and maternal age ranged from 16 to 42 years. Mean gestational age at baseline was 14 weeks. The response rate (RR) for both groups were 100%. The compliance was good in both groups and no adverse side effects were reported. At first visit, the haemoglobin and ferritin level in the daily group was 10.4g/l and 71.7µg/l and for weekly group was 10.5g/l and 79.4µg/l respectively. After 8 weeks of iron supplementation, the hemoglobin and ferritin level in daily group was 10.5g/l and 74.4µg/l and in the weekly group was 10.2g/l and 78.6µg/l respectively. Iron supplementation among mildly anemic women in either daily or weekly groups did not show any significant difference in the hemoglobin(p= 0.078) and ferritin levels(p= 0.933) after 8 weeks. THE EFFEECTIVENESS OF WEEKLY VERSUS DAILY IRON SUPPLEMENTATION AMONG MILD ANEMIC PREGNANT WOMEN Adibah Hanim Ismail1, Haniza Hashim2, Juwita Shaaban2 1Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia 43400 Serdang, Selangor. 2Department of Family Medicine ,School of Medical Sciences, Universiti Sains Malaysia,16150 Kubang Kerian, Kelantan. OPTIONALLOGO HERE OPTIONALLOGO HERE Methods Results Objectives Conclusions Prevalence of anemia among pregnant women in Malaysia was 35%. Majority fall into mild type of anemia and iron deficiency is the predominant cause. The prevalence was higher in the teenage group, grandmultiparas and the third trimester pregnancy1. In Kubang Kerian district of Kelantan, similar finding was found among pregnant women in which 34.6% were anemic during their first antenatal visit. The majority had mild anemia with iron deficiency was the predominant cause2. Studies in pregnant and non pregnant women suggested that supplementation on a weekly basis was as effective as daily supplementation in improving the iron status of those with moderate anemia3,4. Current strategies to prevent and correct iron deficiency and anemia in pregnant women have met with little success. To study This study was designed to determine the effectiveness of weekly versus daily iron supplements among mild anemic pregnant women attending antenatal clinic at a Maternal and Child Health Clinic at Klinik Kesihatan Bandar Kota Bharu, Kelantan. Randomized controlled trial was done over a six- month period. Thirty-five pregnant women at 12-20 weeks of pregnancy with Hb level of 9-11gm/dL were enrolled in this study. Patients were randomized to two treatment group ie daily and weekly groups. The iron tablets were distributed by the investigator at the clinic for a month supply. Patient in the daily group received 200mg of ferrous fumarate to be ingested daily, whereas those in weekly group also received 200mg of ferrous fumarate but advice to ingest two tablets once a week. Hemoglobin and serum ferritin level were taken at first visit and 8 weeks later. A complete set of data was obtained for 35 women in the group supplemented daily and for 35 women in the group supplemented weekly. Majority (92.9%) of the participants were Malays and maternal age ranged from 16 to 42 years. Mean gestational age at baseline was 14 weeks. The response rate (RR) for both groups were 100%. The compliance was good in both groups and no adverse side effects were reported. At first visit, the haemoglobin and ferritin level in the daily group was 10.4g/l and 71.7µg/l and for weekly group was 10.5g/l and 79.4µg/l respectively. After 8 weeks of iron supplementation, the hemoglobin and ferritin level in daily group was 10.5g/l and 74.4µg/l and in the weekly group was 10.2g/l and 78.6µg/l respectively. Iron supplementation among mildly anemic women in either daily or weekly groups did not show any significant difference in the hemoglobin(p= 0.078) and ferritin levels(p= 0.933) after 8 weeks. The supplementation of mild anemic pregnant women with 200 mg ferrous fumarate daily was as effective as weekly 400 mg ferrous fumarate in terms of hemoglobin and ferritin response under conditions resembling the routine antenatal care. References • Haniff J, Das A, Lim T, Chen W, Noraihan M, Rampal S. Anemia in pregnancy in Malaysia: a cross-sectional survey. Asia Pac J ClinNutr 2007;16(3):527-36. • Hassan R, Wan Abdullah WZ, NikHussain NH. Anemia and iron status of women attending an antenatal clinic in KubangKerian, Kelantan, Malaysia. Southeast Asian J Trop Med Public Health. 2005;36(5):1304-7. • Ridwan E, Schultink W, Dillon D, Gross R. Effects of weekly iron supplementation on pregnant Indonesian women are similar to those of daily supplementation. Am J ClinNutr. 1996 Jun;63(6):884-90. • Gross R, Schultink W, Juliawati R. Treatment of anemia with weekly iron supplementation. Lancet. 1994;344:821. • Correspondent: Dr AdibahHanim Bt Ismail, Family Medicine Specialist, Universiti Putra Malaysia, Serdang, Selangor. • E-mail: nasuha9999@yahoo.com • Source of funding: Incentive grants from UniversitiSains Malaysia, Kubangkerian, Kelantan.Malaysia.

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