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Meta-Analysis
. 2024 Aug 15;8(8):CD004736.
doi: 10.1002/14651858.CD004736.pub6.

Daily oral iron supplementation during pregnancy

Julia L Finkelstein  1 , Anna Cuthbert  2 , Jo Weeks  2 , Sudha Venkatramanan  1 , Doreen Y Larvie  1 , Luz Maria De-Regil  3 , Maria Nieves Garcia-Casal  4
Affiliations
Meta-Analysis

Daily oral iron supplementation during pregnancy

Julia L Finkelstein et al. Cochrane Database Syst Rev. .

Abstract

Background: Iron and folic acid supplementation have been recommended in pregnancy for anaemia prevention, and may improve other maternal, pregnancy, and infant outcomes.

Objectives: To examine the effects of daily oral iron supplementation during pregnancy, either alone or in combination with folic acid or with other vitamins and minerals, as an intervention in antenatal care.

Search methods: We searched the Cochrane Pregnancy and Childbirth Trials Registry on 18 January 2024 (including CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, WHO's International Clinical Trials Registry Platform, conference proceedings), and searched reference lists of retrieved studies.

Selection criteria: Randomised or quasi-randomised trials that evaluated the effects of oral supplementation with daily iron, iron + folic acid, or iron + other vitamins and minerals during pregnancy were included.

Data collection and analysis: Review authors independently assessed trial eligibility, ascertained trustworthiness based on pre-defined criteria, assessed risk of bias, extracted data, and conducted checks for accuracy. We used the GRADE approach to assess the certainty of the evidence for primary outcomes. We anticipated high heterogeneity amongst trials; we pooled trial results using a random-effects model (average treatment effect).

Main results: We included 57 trials involving 48,971 women. A total of 40 trials compared the effects of daily oral supplements with iron to placebo or no iron; eight trials evaluated the effects of iron + folic acid compared to placebo or no iron + folic acid. Iron supplementation compared to placebo or no iron Maternal outcomes: Iron supplementation during pregnancy may reduce maternal anaemia (4.0% versus 7.4%; risk ratio (RR) 0.30, 95% confidence interval (CI) 0.20 to 0.47; 14 trials, 13,543 women; low-certainty evidence) and iron deficiency at term (44.0% versus 66.0%; RR 0.51, 95% CI 0.38 to 0.68; 8 trials, 2873 women; low-certainty evidence), and probably reduces maternal iron-deficiency anaemia at term (5.0% versus 18.4%; RR 0.41, 95% CI 0.26 to 0.63; 7 trials, 2704 women; moderate-certainty evidence), compared to placebo or no iron supplementation. There is probably little to no difference in maternal death (2 versus 4 events, RR 0.57, 95% CI 0.12 to 2.69; 3 trials, 14,060 women; moderate-certainty evidence). The evidence is very uncertain for adverse effects (21.6% versus 18.0%; RR 1.29, 95% CI 0.83 to 2.02; 12 trials, 2423 women; very low-certainty evidence) and severe anaemia (Hb < 70 g/L) in the second/third trimester (< 1% versus 3.6%; RR 0.22, 95% CI 0.01 to 3.20; 8 trials, 1398 women; very low-certainty evidence). No trials reported clinical malaria or infection during pregnancy. Infant outcomes: Women taking iron supplements are probably less likely to have infants with low birthweight (5.2% versus 6.1%; RR 0.84, 95% CI 0.72 to 0.99; 12 trials, 18,290 infants; moderate-certainty evidence), compared to placebo or no iron supplementation. However, the evidence is very uncertain for infant birthweight (MD 24.9 g, 95% CI -125.81 to 175.60; 16 trials, 18,554 infants; very low-certainty evidence). There is probably little to no difference in preterm birth (7.6% versus 8.2%; RR 0.93, 95% CI 0.84 to 1.02; 11 trials, 18,827 infants; moderate-certainty evidence) and there may be little to no difference in neonatal death (1.4% versus 1.5%, RR 0.98, 95% CI 0.77 to 1.24; 4 trials, 17,243 infants; low-certainty evidence) or congenital anomalies, including neural tube defects (41 versus 48 events; RR 0.88, 95% CI 0.58 to 1.33; 4 trials, 14,377 infants; low-certainty evidence). Iron + folic supplementation compared to placebo or no iron + folic acid Maternal outcomes: Daily oral supplementation with iron + folic acid probably reduces maternal anaemia at term (12.1% versus 25.5%; RR 0.44, 95% CI 0.30 to 0.64; 4 trials, 1962 women; moderate-certainty evidence), and may reduce maternal iron deficiency at term (3.6% versus 15%; RR 0.24, 95% CI 0.06 to 0.99; 1 trial, 131 women; low-certainty evidence), compared to placebo or no iron + folic acid. The evidence is very uncertain about the effects of iron + folic acid on maternal iron-deficiency anaemia (10.8% versus 25%; RR 0.43, 95% CI 0.17 to 1.09; 1 trial, 131 women; very low-certainty evidence), or maternal deaths (no events; 1 trial; very low-certainty evidence). The evidence is uncertain for adverse effects (21.0% versus 0.0%; RR 44.32, 95% CI 2.77 to 709.09; 1 trial, 456 women; low-certainty evidence), and the evidence is very uncertain for severe anaemia in the second or third trimester (< 1% versus 5.6%; RR 0.12, 95% CI 0.02 to 0.63; 4 trials, 506 women; very low-certainty evidence), compared to placebo or no iron + folic acid. Infant outcomes: There may be little to no difference in infant low birthweight (33.4% versus 40.2%; RR 1.07, 95% CI 0.31 to 3.74; 2 trials, 1311 infants; low-certainty evidence), comparing iron + folic acid supplementation to placebo or no iron + folic acid. Infants born to women who received iron + folic acid during pregnancy probably had higher birthweight (MD 57.73 g, 95% CI 7.66 to 107.79; 2 trials, 1365 infants; moderate-certainty evidence), compared to placebo or no iron + folic acid. There may be little to no difference in other infant outcomes, including preterm birth (19.4% versus 19.2%; RR 1.55, 95% CI 0.40 to 6.00; 3 trials, 1497 infants; low-certainty evidence), neonatal death (3.4% versus 4.2%; RR 0.81, 95% CI 0.51 to 1.30; 1 trial, 1793 infants; low-certainty evidence), or congenital anomalies (1.7% versus 2.4; RR 0.70, 95% CI 0.35 to 1.40; 1 trial, 1652 infants; low-certainty evidence), comparing iron + folic acid supplementation to placebo or no iron + folic acid. A total of 19 trials were conducted in malaria-endemic countries, or in settings with some malaria risk. No studies reported maternal clinical malaria; one study reported data on placental malaria.

Authors' conclusions: Daily oral iron supplementation during pregnancy may reduce maternal anaemia and iron deficiency at term. For other maternal and infant outcomes, there was little to no difference between groups or the evidence was uncertain. Future research is needed to examine the effects of iron supplementation on other maternal and infant health outcomes, including infant iron status, growth, and development.

Trial registration: ClinicalTrials.gov NCT01119612 NCT02221752 NCT01418664 NCT00860470.

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Conflict of interest statement

We certify that we have no affiliations with or involvement in any organisation or entity with a direct financial interest in the subject matter of the review (e.g. employment, consultancy, stock ownership, honoraria, expert testimony).

Dr Julia L Finkelstein is a principal investigator on research grants to examine the burden and aetiology of anaemia in women of reproductive age (U.S. Centers for Disease Control and Prevention), biomarkers of nutritional status in women of reproductive age (National Institutes of Health), and to conduct randomised trials with micronutrient interventions to improve the health of women of reproductive age (U.S. Centers for Disease Control and Prevention). Dr. Finkelstein has no known conflicts of interest to declare.

Anna Cuthbert was employed by the Cochrane Pregnancy and Childbirth Group, at the University of Liverpool, for a project that included work on this review. The project was also funded by the Children’s Investment Foundation Fund (CIFF). Anna Cuthbert has no known conflicts of interests to declare.

Jo Weeks was employed by the University of Liverpool for a project that included the work on this review. The project was also funded by the Children’s Investment Foundation Fund (CIFF). Jo Weeks has no known conflicts of interests to declare.

Sudha Venkatramanan has no known conflicts of interest to declare.

Doreen Y Larvie has no known conflicts of interest to declare.

Luz Maria De‐Regil is a full‐time staff member of the World Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the decisions, policy or views of the World Health Organization. Luz Maria De‐Regil has no known conflicts of interest to declare.

Maria Nieves Garcia‐Casal is a full‐time staff member of the World Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the decisions, policy or views of the World Health Organization. Maria Nieves Garcia‐Casal has no known conflicts of interest to declare.

None of the authors are investigators in any trials included in this review.

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    1. Svanberg B, Arvidsson B, Norrby A, Rybo G, Solvell L. Absorption of supplemental iron during pregnancy - a longitudinal study with repeated bone marrow studies and absorption measurements. Acta Obstetricia et Gynecologica Scandinavica 1975;48:87-108. - PubMed
Taylor 1982 {published and unpublished data}
    1. Taylor DJ, Lind T. Red cell mass during and after normal delivery. British Journal of Obstetrics and Gynaecology 1979;86(5):364-70. - PubMed
    1. Taylor DJ, Mallen C, McDougall N, Lind T. Effect of iron supplementation on serum ferritin levels during and after pregnancy. British Journal of Obstetrics and Gynaecology 1982;89:1011-7. - PubMed
    1. Taylor DJ, Mallen C, McDougall N, Lind T. Personal communication 1982.
Tholin 1993 {published data only}
    1. Tholin K, Hallmans G, Sandstrom B, Goop M, Palm R, Abrahamsson M. Serum zinc, iron supplementation and pregnancy outcome. In: TEMA 8: Proceedings of the Eighth International Symposium on Trace Elements in Man and Animals; 1993 May 16-22; Dresden, Germany. 1993:894-5.
    1. Tholin K, Sandstrom B, Palm R, Hallmans G. Changes in blood manganese levels during pregnancy in iron supplemented and non supplemented women. Journal of Trace Elements in Medicine and Biology 1995;9(1):13-7. - PubMed
Tura 1989 {published data only}
    1. Tura S, Carenza L, Baccarani M, Bagnara M, Bocci A, Bottone P, et al. Therapy and iron supplements with ferritin during pregnancy. A randomized prospective study of 458 cases. Recenti Progessi in Medicina 1989;80:607-14. - PubMed
Van Eijk 1978 {published data only}
    1. Van Eijk HG, Kroos MJ, Hoogendoorn GA, Wallenburg HC. Serum ferritin and iron stores during pregnancy. Clinica Chimica Acta 1978;83(1-2):81-91. - PubMed
Wallenburg 1983 {published data only}
    1. Buytaert G, Wallenburg HC, Van Eijk HG, Buytaert P. Iron supplementation during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 1983;15:11-6. - PubMed
    1. Wallenburg HC, Van Eijk HG. Effect of oral iron supplementation during pregnancy on maternal and fetal iron status. Journal of Perinatal Medicine 1984;12:7-12. - PubMed
Willoughby 1967 {published data only}
    1. Willoughby ML, Jewell FG. Folate status throughout pregnancy and in postpartum period. British Medical Journal 1968;4:356-60. - PMC - PubMed
    1. Willoughby ML, Jewell FJ. Investigation of folic acid requirements in pregnancy. British Medical Journal 1966;2(5529):1568-71. - PMC - PubMed
    1. Willoughby ML. An investigation of folic acid requirements in pregnancy. II. British Journal of Haematology 1967;13:503-9. - PubMed
Wills 1947 {published data only}
    1. Wills L, Hill G, Bingham K, Miall M, Wrigley J. Haemoglobin levels in pregnancy: the effect of the rationing scheme and routine administration of iron. British Journal of Nutrition 1947;1:126-38. - PubMed
Zeng 2008 (C) {published data only (unpublished sought but not used)}
    1. Chang S, Zeng L, Brouwer ID, Kok FJ, Yan H. Effect of iron deficiency anemia in pregnancy on child mental development in rural China. Pediatrics 2013;131(3):e755-63. - PubMed
    1. Cheng Y, Dibley MJ, Zhang X, Zeng L, Yan H. Assessment of dietary intake among pregnant women in a rural area of western China. BMC Public Health 2009;9(9):222. - PMC - PubMed
    1. Feng H, Huang L, Shan J, Zhu Y, Wang L, Qi Q, et al. Whether antenatal micronutrient supplementation having benefit on offspring blood pressure? A 14-year follow-up of a randomized controlled trial in China and meta-analysis. Current Developments in Nutrition 2023;7 Suppl 1:P07-018-23. [DOI: 10.1016/j.cdnut.2023.101009] - DOI
    1. Li C, Zeng L, Wang D, Yang W, Dang S, Zhou J, et al. Prenatal micronutrient supplementation is not associated with intellectual development of young school-aged children. Journal of Nutrition 2015;145(8):1844-9. [CENTRAL: CN-01090893] 1821457 [EMBASE: 605610487] [PMID: ] - PubMed
    1. Li Q, Yan H, Zeng L, Cheng Y, Liang W, Dang S, et al. Effects of maternal multimicronutrient supplementation on the mental development of infants in rural western China: follow-up evaluation of a double-blind, randomized, controlled trial. Pediatrics 2009;123(4):e685-92. - PubMed
Zhao 2014 {published data only}
    1. Li M, Sturza J, Lozoff B. Iron and behaviors relevant to autism spectrum disorder (ASD): randomized controlled trial (RCT) of pre- and/or postnatal iron supplementation. In: Pediatric Academic Societies Annual Meeting; 2015 April 25-28; San Diego, California, USA. 2015. 6731234
    1. Pedley M, Brown N. Improving motor development in infancy with iron supplementation. Archives of Disease in Childhood: Education and Practice Edition 2016;101(6):1. 12437102 [EMBASE: 626607114] - PubMed
    1. Zhao G, Xu G, Zhou M, Jiang Y, Richards B, Clark KM, et al. Prenatal iron supplementation improves maternal but not neonatal iron status: a randomized clinical trial in rural China. In: Pediatric Academic Societies Annual Meeting; 2015 April 25-28; San Diego, California, USA. 2015. 6731242
    1. Zhao G, Xu G, Zhou M, Jiang Y, Richards B, Clark KM, et al. Prenatal iron supplementation reduces maternal anemia, iron deficiency, and iron deficiency anemia in a randomized clinical trial in rural China, but iron deficiency remains widespread in mothers and neonates. Journal of Nutrition 2015;145(8):1916-23. [CENTRAL: CN-01090890] 1821454 [EMBASE: 2015294057] [PMID: ] - PMC - PubMed
    1. Zhao G. Impact of iron/folic acid versus folic acid supplements during pregnancy on maternal and children's health: a randomized controlled trial in China. ClinicalTrials.gov (http://Clinicaltrials.gov/) (accessed 27 August 2014) 2014.

References to studies excluded from this review

Aaseth 2001 {published data only}
    1. Aaseth J, Thomassen Y, Ellingsen DG, Stoa-Birketvedt G. Prophylactic iron supplementation in pregnant women in Norway. Journal of Trace Elements in Medicine and Biology 2001;15(2-3):167-74. - PubMed
Abel 2000 {published data only}
    1. Abel R, Rajaratnam J, Kalaimani A, Kirubakaran S. Can iron status be improved in each of the three trimesters? A community base study. European Journal of Clinical Nutrition June;54:490-3. [DOI: 10.1038/sj.ejcn.1601044] - DOI - PubMed
Adaji 2019 {published data only}
    1. Adaji JA, Isah AY, Agida ET, Otu T, Abdullahi HI. Daily versus twice daily dose of ferrous sulphate supplementation in pregnant women: a randomized clinical trial. Nigerian Journal of Clinical Practice 2019;22(8):1132-9. [CENTRAL: CN-01999876] 12300980 [PMID: ] - PubMed
Adhikari 2009 {published data only}
    1. Adhikari K, Liabsuetrakul T, Pradhan N. Effect of education and pill count on hemoglobin status during prenatal care in Nepalese women: a randomized controlled trial. Journal of Obstetrics and Gynaecology Research 2009;35(3):459-66. - PubMed
Afifi 1978 {published data only}
    1. Afifi AM. Plexafer-F in the management of latent iron deficiency in pregnancy. Journal of International Medical Research 1978;6:34-40. - PubMed
Agrawal 2011 {published data only}
    1. Agrawal N. Impact of two oral iron supplementation regimens (intermittently and continuously/daily) for prevention of anaemia in pregnancy in women with normal haemoglobin levels. Clinical Trials Registry - India (accessed 31 May 2013) 2011.
Ahamed 2018 {published data only}
    1. Ahamed F, Yadav K, Kant S, Saxena R, Bairwa M, Pandav CS. Effect of directly observed oral iron supplementation during pregnancy on iron status in a rural population in Haryana: a randomized controlled trial. Indian Journal of Public Health 2018;62(4):287-93. [CENTRAL: CN-01764532] 10385576 [EMBASE: 625525509] [PMID: ] - PubMed
Ahn 2006 {published data only}
    1. Ahn E, Pairaudeau N, Pairaudeau N, Cerat Y, Couturier B, Fortier A, et al. A randomized cross over trial of tolerability and compliance of a micronutrient supplement with low iron separated from calcium vs high iron combined with calcium in pregnant women. BMC Pregnancy and Childbirth 2006;6:10. - PMC - PubMed
Alaoddolehei 2012 {published data only}
    1. Alaoddolehei H, Samiei H, Sadighian F, Kalantari N. Efficacy of daily versus intermittent administration of iron supplementation in anemia or blood indices during pregnancy. Caspian Journal of Internal Medicine 2012;4(1):569-73. - PMC - PubMed
Ali 2016 {published data only}
    1. Ali MK, Abbas AM, Abdelmagied AM, Mohammed GE, Abdalmageed OS. A randomized clinical trial of the efficacy of single versus double-daily dose of oral iron for prevention of iron deficiency anemia in women with twin gestations. Journal of Maternal-Fetal & Neonatal Medicine 2016;30(23):2884-9. [CENTRAL: CN-01604812] 6816098 [PMID: ] - PubMed
    1. NCT02858505. Impact of one versus two amino acid chelated iron capsules on prevention of iron deficiency anemia in non-anemic women with twin gestations. https://clinicaltrials.gov/show/nct02858505 (first received 2 August 2016). [CENTRAL: CN-01592303] 8480846
Angeles‐Agdeppa 2003 {published data only (unpublished sought but not used)}
    1. Angeles-Agdeppa I, Paulino LS, Ramos AC, Etorma UM, Cavalli-Sforza T, Milani S. Government-industry partnership in weekly iron-folic acid supplementation for women of reproductive age in the Philippines: impact on iron status. Nutrition Reviews 2005;63(12 Pt 2):S116-25. - PubMed
    1. Angeles-Agdeppa I. The effects of a community-based weekly iron-folate supplementation on hemoglobin and iron status of pregnant and non-pregnant women in Philippines. Meeting on weekly iron/folic acid supplementation for preventing anaemia in women of reproductive age in the Western Pacific Region report; 2003 Sept 29 to Oct 1; Manila, Philippines. WHO, 2003.
    1. Paulino LS, Angeles-Agdeppa I, Etorma UM, Ramos AC, Cavalli-Sforza T. Weekly iron-folic acid supplementation to improve iron status and prevent pregnancy anemia in Filipino women of reproductive age: the Philippine experience through government and private partnership. Nutrition Reviews 2005;63(12 Pt 2):S109-15. - PubMed
Angulo‐Barroso 2016 {published data only}
    1. Angulo-Barraso RM, Li M, Santos DC, Bian Y, Zhang Z, Tardif TZ, et al. Iron deficiency and infant gross motor development: linked randomized controlled trials of pre- and/or postnatal iron supplementation. In: Pediatric Academic Societies Annual Meeting. San Diego, California, USA, 2015. [CENTRAL: CN-01343359]
    1. Angulo-Barroso RM, Li M, Santos DC, Bian Y, Sturza J, Jiang Y, et al. Iron supplementation in pregnancy or infancy and motor development: a randomized controlled trial. Pediatrics 2016;137(4):e20153547. [CENTRAL: CN-01140640] [EMBASE: 609646949] [PMID: ] - PMC - PubMed
Antonia 2023 {published data only}
    1. Antonia S, Giselle KG, Luke G, Natasha N, Jennifer G, Donna L, et al. The Iron Woman Pilot Study: a double blind randomised trial to compare intravenous or oral iron replacement to placebo intravenous or oral therapy for iron deficiency anaemia in pregnancy. Journal of Paediatrics and Child Health 2023;59:152‐3. [DOI: 10.1111/jpc.16383] - DOI
Arija 2014 {published data only}
    1. Arija V, Fargas F, March G, Abajo S, Basora J, Canals J, et al. Adapting iron dose supplementation in pregnancy for greater effectiveness on mother and child health: protocol of the ECLIPSES randomized clinical trial. BMC Pregnancy and Childbirth 2014;14(1):33. - PMC - PubMed
Babior 1985 {published data only}
    1. Babior BM, Peters WA, Briden PM, Cetrulo CL. Pregnant women's absorption of iron from prenatal supplements. Journal of Reproductive Medicine 1985;30:355-7. - PubMed
Bah 2019 {published data only}
    1. Bah A, Muhammad AK, Wegmuller R, Verhoef H, Goheen MM, Sanyang S, et al. Hepcidin-guided screen-and-treat interventions against iron-deficiency anaemia in pregnancy: a randomised controlled trial in The Gambia. Lancet. Global Health 2019;7(11):e1564-74. [CENTRAL: CN-01995701] 12198586 [EMBASE: 2003305315] [PMID: ] - PMC - PubMed
    1. Bah A, Wegmuller R, Cerami C, Kendall L, Pasricha SR, Moore SE, et al. A double blind randomised controlled trial comparing standard dose of iron supplementation for pregnant women with two screen-and-treat approaches using hepcidin as a biomarker for ready and safe to receive iron. BMC Pregnancy and Childbirth 2016;16(1):157. [CENTRAL: CN-01424968] 6731699 [EMBASE: 611403809] [PMID: ] - PMC - PubMed
Balmelli 1974 {published data only}
    1. Balmelli GP, Huser HJ. Folic acid deficiency in pregnant women in Switzerland [Zur Frage des Folsäuremangels beiSchwangeren in der Schweiz]. Schweizerische Medizinische Wochenschrift 1974;104(10):351-6. - PubMed
Bencaiova 2007 {published data only (unpublished sought but not used)}
    1. Bencaiova G, Mandach U, Zimmerman R. Optimal prophylaxis of a lack of iron and iron-deficiency anemia in the pregnancy: a randomized study [Optimale Prophylaxe e Ines Elsenmangels und elner Eisenmangelanamie In der Schwangerschaft: eine randomisierte Studie]. Gynakologisch-geburtshilfliche Rundschau 2007;47:140.
    1. Bencaiova G, Mandach U, Zimmermann R. Iron prophylaxis in pregnancy: intravenous route versus oral route. European Journal of Obstetrics & Gynecology and Reproductive Biology 2009;144(2):135-9. - PubMed
Berger 2003 {published data only (unpublished sought but not used)}
    1. Berger J, Thanh HT, Cavalli-Sforza T, Smitasiri S, Khan NC, Milani S, et al. Community mobilization and social marketing topromote weekly iron-folic acid supplementation in women of reproductive age in Vietnam: impact on anemia and iron status. Nutrition Reviews 2005;63(12 Pt 2):S95-108. - PubMed
    1. Berger J. Effectiveness of weekly iron/folate supplementation on anaemia and iron status in women of reproductive age inrural Viet Nam. In: Meeting on weekly iron/folic acid supplementation for preventing anaemia in women of reproductive age in the Western Pacific Region report 2003 Sept 29-Oct 1; Manila, Philippines. Manila, Philippines: WHO, 2003.
    1. Hoa PT, Berger J, Paliakara N, Nhien NV, Morestin-Cadet S, Quyen DT, et al. Weekly iron-folate supplementation in womenin reproductive age in Vietnam: a new approach to control iron deficiency anemia during pregnancy. INACG Symposium; 2001 Feb 15-16; Hanoi, Vietnam 2001:45 (Abstract No: 18).
    1. Khan NC, Thanh HT, Berger J, Hoa PT, Quang ND, Smitasiri S, et al. Community mobilization and social marketing topromote weekly iron-folic acid supplementation: a new approach toward controlling anemia among women ofreproductive age in Vietnam. Nutrition Reviews 2005;63(12 Pt 2):S87-94. - PubMed
Bergsjo 1987 {published data only}
    1. Bergsjo P. The effects of iron supplementation in pregnancy. Personal communication 1987.
Bhatla 2009 {published data only}
    1. Bhatla N, Kaul N, Lal N, Kriplani A, Agarwal N, Saxena R, et al. Comparison of effect of daily versus weekly iron supplementation during pregnancy on lipid peroxidation. Journal of Obstetrics and Gynaecology Research 2009;35(3):438-45. - PubMed
Bhatt 2020 {published data only}
    1. Bhatt A, Vinayak N, Acharya N. Role of intravenous iron sucrose in comparison to oral ferrous sulfate for prophylaxis of anemia in pregnant women. Journal of Datta Meghe Institute of Medical Sciences University 2020;15:12-5. [CENTRAL: CN-02494422] 16898496
Blot 1980 {published data only}
    1. Blot I, Papiernik E, Kalwatsser JP, Werner E, Tchernia G. Influence of routine administration of folic acid and iron during pregnancy. Gynecologic and Obstetric Investigation 1981;12:294-304. - PubMed
    1. Blot I, Tchernia G, Chenayer M, Hill C, Hajeri H, Leluc R. Iron deficiency in the pregnant woman. Its repercussions on the newborn. The influence of systematic iron treatment. Journal de Gynecologie, Obstetrique et Biologie de la Reproduction 1980;9:489-95. - PubMed
    1. Tchernia G, Blot I, Rey A, Kaltwasser JP, Zittoun J, Papiernik E. Maternal folate status, birthweight and gestational age. Developmental Pharmacology Therapeutics 1982;4 Suppl:58-65. - PubMed
    1. Zittoun J, Blot I, Hill C, Zittoun R, Papiernik E, Tchernia G. Iron supplements vs placebo during pregnancy: its effects on iron and folate status on mothers and newborns. Annals of Nutrition & Metabolism 1983;27:320-7. - PubMed
Bokhari 2011 {published data only}
    1. Bokhari EJ. A functional food for the prevention of iron-deficiency anemia. ClinicalTrial.gov (http://Clinicaltrials.gov) (accessed 19 July 2011) 2011.
    1. Bokhari F, Derbyshire EJ, Li W, Brennan CS. Can an iron-rich staple food help women to achieve dietary targets in pregnancy? International Journal of Food Sciences and Nutrition 2012;63(2):199-207. - PubMed
Bokhari 2012 {published data only}
    1. Bokhari F, Derbyshire EJ, Hickling D, Li W, Brennan CS. A randomized trial investigating an iron-rich bread as a prophylaxis against iron deficiency in pregnancy. International Journal of Food Sciences and Nutrition 2012;63(4):461-7. - PubMed
Breymann 2015 {published data only}
    1. Breymann C, Milman N, Mezzacasa A, Dudenhausen J. The efficacy and tolerability of intravenous ferric carboxymaltose versus oral iron in pregnant women with iron deficiency anemia-the FER-ASAP study. International Journal of Gynaecology and Obstetrics 2015;131:E243-4. [CENTRAL: CN-01106623] 1837132 [EMBASE: 72069494]
Brown 1972 {published data only}
    1. Brown GM, Dawson DW. Prevention of anaemia in pregnancy. Current Medical Research and Opinion 1972;1:93-9. - PubMed
Burslem 1968 {published data only}
    1. Burslem RW, Poller L, Wacks H. A trial of slow release ferrous sulphate (Ferrogradumet) in prevention of iron deficiency in pregnancy. Acta Haematologica 1968;40:200-4. - PubMed
Buss 1981 {published data only}
    1. Buss M. Therapy of iron-folic acid deficiency in pregnancy [Therapie des Eisen-Folsauremangels in der Schwangerschaft]. Zeitschrift fur Allgemeinmedizin 1981;57(22):1526-32. - PubMed
Callaghan‐Gillespie 2017 {published data only}
    1. Callaghan-Gillespie M, Schaffner AA, Garcia P, Fry J, Eckert R, Malek S, et al. Trial of ready-to-use supplemental food and corn-soy blend in pregnant Malawian women with moderate malnutrition: a randomized controlled clinical trial [Randomized controlled trial of the impact of treating moderately malnourished women in pregnancy]. American Journal of Clinical Nutrition 2017;106(4):1062-9. [CENTRAL: CN-01419710] 7107677 [EMBASE: 618943198] [PMID: ] - PMC - PubMed
    1. NCT02120599. Interventions for moderate malnutrition in pregnancy [Randomized controlled trial of the impact of treating moderately malnourished women in pregnancy]. https://clinicaltrials.gov/show/nct02120599 (first received 18 April 2014). [CENTRAL: CN-01545222] 11695085
Carrasco 1962 {published data only}
    1. Carrasco E, Jose F, Samson G, Germar E, Padilla B. Effect of D-sorbitol on the absorption and transfer of nutrients from mother to fetus. American Journal of Clinical Nutrition 1962;11:533-6. - PubMed
Casanueva 2003a {published and unpublished data}
    1. Casanueva E, Viteri FE, Mares-Galindo M, Meza-Camacho C, Loria A, Schnaas L, et al. Weekly iron as a safe alternative to daily supplementation for nonanemic pregnant women. Archives of Medical Research 2006;37(5):674-82. - PubMed
    1. Casanueva E. Weekly iron-folate (Fe-fol) supplementation during pregnancy in Mexican women. Personal communication 2003.
Castren 1968 {published data only}
    1. Castren O, Levanto A, Rauramo L, Ruponen S. Preventive iron and folic acid therapy in pregnancy. Annales Chirurgiae et Gynaecologiae Fenniae 1968;57:382-6. - PubMed
Chanarin 1968 {published data only}
    1. Chanarin I, Rothman D, Ward A, Perry J. Folate status and requirement in pregnancy. British Medical Journal 1968;2:390-4. - PMC - PubMed
Chawla 1995 {published data only}
    1. Chawla PK, Puri R. Impact of nutritional supplements on hematological profile of pregnant women. Indian Pediatrics 1995;32:876-80. - PubMed
Chew 1996a {published and unpublished data}
    1. Chew F, Torun B, Viteri FE. Comparison of weekly and daily iron supplementation to pregnant women in Guatemala (supervised and unsupervised). FASEB Journal 1996;10:A4221.
    1. Chew F, Torun B, Viteri FE. Individual patient data (as supplied 15 January 2004). Data on file.
    1. Chew F, Torún B, Viteri FE. Comparison of daily and weekly iron supplementation in pregnant women with and without direct supervision [Comparación de la suplementación diaria o semanal de hierro en mujeres embarazadas con y sin supervisión directa]. In: XI Congreso Latino Americano de Nutrición, Libro de Resumenes. Guatemala: SLAN, 1997:94.
Chew 1996b {published and unpublished data}
    1. Chew F, Torun B, Viteri FE. Comparison of weekly and daily iron supplementation to pregnant women in Guatemala (supervised and unsupervised). FASEB Journal 1996;10:A4221.
    1. Chew F, Torun B, Viteri FE. Individual patient data (as supplied 15 January 2004). Data on file.
    1. Chew F, Torún B, Viteri FE. Comparison of daily and weekly iron supplementation in pregnant women with and without direct supervision [Comparación de la suplementación diaria o semanal de hierro en mujeres embarazadas con y sin supervisión directa]. In: XI Congreso Latino Americano de Nutrición, Libro de Resumenes. Guatemala: SLAN, 1997:94.
ChiCTR1800017574 (first received 2018) {published data only}
    1. ChiCTR1800017574. Impact of iron-rich food on iron metabolism, gestation status and birth outcomes in pregnant women: a randomized controlled trial. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR1800017574 (first received 2018). [CENTRAL: CN-01908183] 10807866
Coelho 2000 {published data only}
    1. Coelho K, Ramdas S, Pillai S. A comparative study of changes in haemoglobin with high and low dose iron preparations in pregnant women. Journal of Obstetrics and Gynaecology of India 2000;50(2):37-9.
Compaore 2017 {published data only}
    1. Compaore A, Gies S, Brabin BJ, Tinto H, Brabin L. A qualitative study of the acceptability of weekly iron supplementation priorto the first pregnancy in Burkina Faso. Tropical Medicine & International Health 2017;22(Suppl 1):98. [CENTRAL: CN- 01419304] [EMBASE: 618977996]
Cook 1990 {published data only}
    1. Cook JD, Carriaga M, Kahn SG, Schalch W, Skikne BS. Gastric delivery system for iron supplementation. Lancet 1990;335(8698):1136-9. - PubMed
CTRI/2017/10/010057 (first received 2017) {published data only}
    1. CTRI/2017/10/010057. A clinical trial to compare the effects of 60 mg and 100 mg iron in pregnant women for the prevention of iron deficiency anaemia [Randomized controlled trial of 60 mg vs 100 mg elemental iron with fixed dose of 0.5 mg folic acid oral supplementation for iron deficiency anaemia prophylaxis in pregnant women at a secondary care hospital in Haryana]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2017/10/010057 (first received 2017). [CENTRAL: CN-01885476] 10785209
CTRI/2019/08/020917 (first received 2019) {published data only}
    1. CTRI/2019/08/020917. Effect of ayurvedic medicines in combination with conventional therapy for healthy pregnancy and post partum period [Feasibility of introducing Ayurveda intervention in Reproductive and Child Health (RCH) in PHCs of selected district (Gadchiroli) of Maharashtra - (Effectiveness of Ayurvedic Intervention for Ante-Natal care (Garbhini Paricharya) at Primary Health Care level: a Multi Centre Operational Study]. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2019/08/020917 (first received 2019). [CENTRAL: CN-02349411] 19548110
CTRI/2019/09/021372 (first received 2019) {published data only}
    1. CTRI/2019/09/021372. Iron and Vitamin D supplementation for pregnant women [Comprehensive antenatal supplementation on Hb status of pregnant women]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2019/09/021372 (first received 2019). [CENTRAL: CN-02066543] 12853389
CTRI/2020/09/028053 (first received 2020) {published data only}
    1. CTRI/2020/09/028053. Garbhavastha me khoon KI kami KI chikitsa [Promoting Health of Garbhini by Amalaki Rasayana (INDIGENOUS)]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2020/09/028053 (first received 2020). [CENTRAL: CN-02186107] 15372388
CTRI/2021/03/032434 (first received 2021) {published data only}
    1. CTRI/2021/03/032434. Role of Jeevantyadi Avaleha on foetal growth and maternal well-being in second trimester of pregnancy [Role of Jeevantyadi Avaleha on foetal growth and maternal well-being in second trimester of pregnancy a?? A randomized controlled clinical trial]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2021/03/032434 (first received 2021). [CENTRAL: CN-02280521] 18208613
CTRI/2021/09/036960 (first received 2021) {published data only}
    1. CTRI/2021/09/036960. A clinical trial to study the garbhini paricharya in 6th and 7th month of pregnanacy [Randomized clinical controlled trial of Sushrutokta Garbhini Paricharya in 6th and 7th month of preganancy]. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2021/09/036960 (first received 2021). [CENTRAL: CN-02349943] 19548619
CTRI/2022/02/040426 (first received 2022) {published data only}
    1. CTRI/2022/02/040426. Intergenerational nutritional supplementation approach for the establishment of a healthy microbiome in pregnant women and her newborn [An intergenerational nutritional supplementation approach for the establishment of a healthy microbiome in pregnant women (taking iron supplementation) and her newborn in a low socioeconomic cohort in Odisha]. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2022/02/040426 (first received 2022). [CENTRAL: CN-02408815] 20994606
Dawson 1962 {published data only}
    1. Dawson DW, More JR, Aird DC. Prevention of megaloblastic anaemia in pregnancy by folic acid. Lancet 1962;2:1015-20. - PubMed
Dawson 1987 {published data only}
    1. Dawson EB, McGanity WJ. Protection of maternal iron stores in pregnancy. Journal of Reproductive Medicine 1987;32(6 Suppl):478-87. - PubMed
Dewey 2019 {published data only}
    1. Dewey KG, Matias SL, Mridha MK, Arnold CD. Nutrient supplementation during the first 1000 days and growth of infants born to pregnant adolescents. Annals of the New York Academy of Sciences 2019;1468(1):25-34. [CENTRAL: CN-01981392] 12082885 [EMBASE: 2002385734] [PMID: ] - PMC - PubMed
Dijkhuizen 2004 {published data only}
    1. Dijkhuizen MA, Wieringa FT, West CE, Muhilal. Zinc plus beta-carotene supplementation of pregnant women is superior to beta-carotene supplementation alone in improving vitamin A status in both mothers and infants. American Journal of Clinical Nutrition 2004;80(5):1299-307. - PubMed
Edgar 1956 {published data only}
    1. Edgar W, Rice HM. Administration of iron in antenatal clinics. Lancet 1956;1:599-602. - PubMed
Eeesha 2022 {published data only}
    1. Eeesha A, Yogita K, Manju T. Pharmacoeconomic evaluation of generic vs branded preparation of ferrous ascorbate in 14 to 24 weeks of gestational women. JK Science 2022;24(1):51-6. [CENTRAL: CN-02401500] 20912195 [EMBASE: 2016477679]
Ekstrom 1996 {published data only}
    1. Ekstrom EM, Kavishe FP, Habicht J, Frongillo EA, Rasmussen KM, Hemed L. Adherence to iron supplementation during pregnancy in Tanzania: determinants and hematologic consequences. American Journal of Clinical Nutrition 1996;64:368-74. - PubMed
Ekstrom 2002 {published and unpublished data}
    1. Ekstrom EC, Hyder SM, Chowdhury AM, Chowdhury SA, Lonnerdal B, Habicht JP, et al. Efficacy and trial effectiveness of weekly and daily iron supplementation among pregnant women in rural Bangladesh: disentangling the issues. American Journal of Clinical Nutrition 2002;76(6):1392-400. - PubMed
    1. Ekstrom EC. Personal communication 12 April 2004.
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EUCTR2012‐005480‐28‐ES (first received 2013) {published data only}
    1. EUCTR2012-005480-28-ES. Effectiveness of adaptation of the dose of iron supplementation in pregnancy on maternal-child health. Randomized clinical trial (ECLIPSES) [Effectiveness of adaptation of the dose of iron supplementation in pregnancy on maternal-child health. Randomized clinical trial (ECLIPSES) - ECLIPSES]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2012-005480-28-ES (first received 2013). [CENTRAL: CN-01880715] 10780463
EUCTR2022‐001815‐25‐IE (first received 2022) {published data only}
    1. Daily versus alternate day oral iron supplementation for the treatment of iron deficiency anaemia in pregnancy (IronMother). https://trialsearch.who.int/Trial2.aspx?TrialID=EUCTR2022-001815-25-IE 2022.
Fletcher 1971 {published data only}
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Goonewardene 2001 {published data only}
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Goshtasebi 2012 {published data only}
    1. Goshtasebi A, Alizadeh M. Impact of twice weekly versus daily iron supplementation during pregnancy on maternal and fetal haematological indices: a randomized clinical trial [Impact d'une prise de complement en fer bihebdomadaire par rapport a une prise quotidienne pendant la grossesse sur des indices hematologiques maternels et foetaux: une etude clinique randomisee]. Eastern Mediterranean Health Journal 2012;18(6):561-6. - PubMed
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Grover 1998 {published data only}
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Guldholt 1991 {published data only}
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    1. Biggs BA. A randomised controlled trial to compare the impact on birth weight of daily iron-folic acid, twice weekly iron-folic acid and twice weekly multiple micronutrient supplementation for pregnant women in Ha Nam province, Vietnam. Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) (accessed 17 January 2011) 2011.
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Hawkins 1987 {published data only}
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Hemminki 1991 {published and unpublished data}
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Hosokawa 1989 {published data only}
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Hossain 2014 {published data only}
    1. Hossain N, Kanani FH, Ramzan S, Kausar R, Ayaz S, Khanani R, et al. Obstetric and neonatal outcomes of maternal vitamin D supplementation: results of an open label randomized controlled trial of antenatal vitamin D supplementation in Pakistani women. Journal of Clinical Endocrinology and Metabolism 2014;99(7):2448-55. - PubMed
Huda 2018 {published data only}
    1. A trial to evaluate the impact of an early start to iron/folic acid supplementation in pregnancy on deaths of newborns in rural Bangladesh. Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) (accessed 2 July 2012) 2012.
    1. Dibley M, Huda TM, Rahman MM, Raihana S, Tahsina T, Rahman QS, et al. Effect of iron-folic acid supplementation starting during early trimester of pregnancy on neonatal mortality: findings from a large community-based randomized controlled trial in rural Bangladesh. Annals of Nutrition & Metabolism 2017;71(Suppl 2):605-6. [CENTRAL: CN-01428882] 7241655 [EMBASE: 619277034]
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Iglesias‐Vazquez 2022 {published data only}
    1. Iglesias-Vazquez L, Canals J, Hernandez-Martinez C, Voltas N, Arija V. Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4-year-old children. Maternal & Child Nutrition 2023;20(1):e13595. [DOI: 10.1111/mcn.13595] - DOI - PMC - PubMed
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ISRCTN77724888 (first received 2017) {published data only}
    1. ISRCTN77724888. Assessing the effect of different doses of iron supplementation in pregnant women [Serum ferritin level in non-anaemic pregnant women on daily versus weekly iron supplement: a randomized control trial]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN77724888 (first received 2017). [CENTRAL: CN-01810350] 10710296
Itam 2003 {published data only}
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Iyengar 1970 {published data only}
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Jones 2021 {published data only}
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Kaestel 2005 {published data only}
    1. Andersen GS, Friis H, Michaelsen KF, Rodrigues A, Benn CS, Aaby P, et al. Effects of maternal micronutrient supplementation on fetal loss and under-2-years child mortality: long-term follow-up of a randomised controlled trial from Guinea-Bissau. African Journal of Reproductive Health 2010;14(2):17-26. - PubMed
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Kann 1988 {published data only}
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Khambalia 2009 {published data only}
    1. Khambalia A, O'Connor D, Zlotkin S. Reduced anemia and improved iron and folate status before and after pregnancy amongfemales in rural Bangladesh is related to length of adherence to periconceptional iron and folic acid supplementation. FASEB Journal 2014;23(1):Abstract no: 917.6.
    1. Khambalia A. Periconceptional Iron Supplementation and Iron and Folate Status Among Pregnant and Non-Pregnant Women in Rural Bangladesh [Thesis]. Toronto: University of Toronto, 2009.
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Khan 2017 {published data only}
    1. Khan AI, Kabir I, Eneroth H, El Arifeen S, Ekstrom EC, Frongilo EA, et al. Effect of a randomised exclusive breastfeeding counselling intervention nested into the MINIMat prenatal nutrition trial in Bangladesh. Acta Paediatrica 2017;106(1):49-54. [CENTRAL: CN-01342405] 5441382 [EMBASE: 613417049] [PMID: ] - PMC - PubMed
Khangura 2021 {published data only}
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Kinnunen 2016 {published data only}
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Kone 2020 {published data only}
    1. Kone S, Utzinger J, Probst-Hensch N, Dao D, Fink G. Study protocol of a cluster randomized controlled trial of strategies to increase antenatal iron and folic acid supplementation and malaria prophylaxis in rural south-central Cote d'Ivoire. BMC Public Health 2020;20(1):1609. [CENTRAL: CN-02202528] 15972526 [EMBASE: 633287787] [PMID: ] - PMC - PubMed
Kulkarni 2010 {published data only}
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Kumar 2005 {published data only}
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Lee 2022 {published data only}
    1. ISRCTN15116516. Enhancing nutrition and infection treatment during pregnancy for maternal and child health in Ethiopia (ENAT) [Effect of antentatal interventions to improve maternal nutritional status and infection control on birth outcomes and infant growth in rural Ethiopia]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN15116516 (first received 2020). [CENTRAL: CN-02188368] 15374458
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Liu 1996 {published and unpublished data}
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Ma 2008 {published data only}
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    1. Marin GH, Mestorino N, Errecalde J, Huber B, Uriarte A, Orchuela J. Personalised iron supply for prophylaxis and treatment of pregnant women as a way to ensure normal iron levels in their breast milk. Journal of Medicine and Life 2012;5(1):29-32. - PMC - PubMed
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    1. Mbaye A, Richardson K, Balajo B, Dunyo S, Shulman C, Milligan P, et al. Lack of inhibition of the anti-malarial action of sulfadoxine-pyrimethamine by folic acid supplementation when used for intermittent preventive treatment in Gambian primigravidae. American Journal of Tropical Medicine and Hygiene 2006;74(6):960-4. - PubMed
McKenna 2002 {published data only (unpublished sought but not used)}
    1. McKenna D, Spence D, Dornan J. A randomised, double-blind, placebo-controlled trial investigating the place of spatone-iron plus as a prophylaxis against iron deficiency in pregnancy [abstract]. Journal of Obstetrics and Gynaecology 2002;22(2 Suppl):S45.
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Mwangi 2015 {published data only}
    1. Braithwaite VS, Demir AY, Mwangi MN, Jones KS, Prentice A, Prentice AM, et al. Antenatal oral iron supplementation, FGF23 and bone metabolism in kenyan women and their offspring: a randomised controlled trial. Journal of the Endocrine Society 2020;4:A218‐9. [DOI: 10.1210/jendso/bvaa046.431] - DOI - PMC - PubMed
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Nadimin 2019 {published data only}
    1. Nadimin, Hadju V, As'ad S, Buchari A, Haruna I, Hartono R. Increasing of nutrition status of pregnant women after supplementation of moringa leaf extract (Moringa oliefera) in the coastal area of Makassar, Indonesia. Indian Journal of Public Health Research and Development 2019;10(1):521-5. [CENTRAL: CN-01917206] 10619948 [EMBASE: 2001568122]
Nadimin 2020 {published data only}
    1. Nadimin, Hadju V, As'ad S, Bukhari A, Arundhana AI, Imrawati. A comparison between extract Moringa oleifera and iron tablet on prevention low birth weight in pregnant mothers in Makassar, Indonesia. Enfermeria Clinica 2020;30 Suppl 4:26-30. [CENTRAL: CN-02142351] 14181532 [EMBASE: 632107358] [PMID: ] - PubMed
NCT03836703 (first received 2019 Feb 11) {published data only}
    1. NCT03836703. Doubling the iron dose to prevent IDA in twin pregnant women [Doubling the iron dose vs single dose iron supplementation to prevent iron deficiency anemia (IDA) in twin pregnant women: a randomized controlled trial]. https://clinicaltrials.gov/show/nct03836703 (first received 11 February 2019). [CENTRAL: CN-01796344] 10410881
NCT04250428 (first received 2020 Jan 31) {published data only}
    1. NCT04250428. Strategies to increase antenatal iron and folic acid supplementation and malaria prophylaxis [Strategies to increase antenatal iron and folic acid supplementation and malaria prophylaxis in rural south-central Cote d'Ivoire: study protocol of a cluster randomised controlled trial]. https://clinicaltrials.gov/show/NCT04250428 (first received 31 January 2020). [CENTRAL: CN-02079943] 12866598 - PMC - PubMed
NCT04363905 (first received 2020 Apr 27) {published data only}
    1. NCT04363905. Supplemental iron improves submaximal exercise performance in non-anemic iron depleted women [Supplemental Iron Improves submaximal exercise performance in non-anemic iron depleted Mexican women: a randomized placebo control trial]. https://clinicaltrials.gov/show/NCT04363905 (first received 27 April 2020). [CENTRAL: CN-02103493]
Nguyen 2008 {published data only}
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Nguyen 2012 {published data only}
    1. Nguyen PH, Young M, Gonzalez-Casanova I, Pham HQ, Nguyen H, Truong TV, et al. Impact of preconception micronutrient supplementation on anemia and iron status during pregnancy and postpartum: a randomized controlled trial in rural Vietnam. PLOS One 2016;11(12):e0167416. [CENTRAL: CN-01382047] 6330227 [EMBASE: 613532278] [PMID: ] - PMC - PubMed
Nguyen 2012a {published data only}
    1. Gonzalez-Casanova I, Nguyen PH, Young MF, Harding KB, Reinhart G, Nguyen H, et al. Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam. BMC Public Health 2017;17(1):452. [CENTRAL: CN-01420280] 6816344 [EMBASE: 618928368] [PMID: ] - PMC - PubMed
Nogueira 2002 {published data only}
    1. Nogueira ND, Macedo AD, Parente JV, Cozzolino SM. Nutritional profile of newborns of adolescent mothers supplemented with iron, in different concentrations, zinc and pholic acid. Revista de Nutricao 2002;15:193-200.
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Nur 2020 {published data only}
    1. Nur R, Demak IP, Radhiah S, Rusydi M, Mantao E, Larasati RD. The effect of moringa leaf extracton increasing hemoglobin and bodyweight in post-disaster pregnant women. Enfermeria Clinica 2020;30:79-82. [CENTRAL: CN-02142509] 14326737 [EMBASE: 632105073] [PMID: ] - PubMed
Nwaru 2015 {published data only}
    1. Nwaru BI, Parkkali S, Abacassamo F, Salome G, Chilundo B, Augusto O, et al. A pragmatic randomised controlled trial on routine iron prophylaxis during pregnancy in Maputo, Mozambique (PROFEG): rationale, design, and success. Maternal & Child Nutrition 2015;11(2):146-63. [CENTRAL: CN-01069474] 1800054 [EMBASE: 52241197] - PMC - PubMed
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Ogunbode 1984 {published data only}
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Ogunbode 1992 {published data only}
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Ortega‐Soler 1998 {unpublished data only}
    1. Ortega-Soler CR, Langini SH, Fleishman S, Lopez LB, Garcia M, Guntin R, et al. Iron nutritional status in pregnant women with and without iron supplementation [Estado nutricional con respecto al hierro (Fe) en gestantes con y sin suplementacion]. Personal communication 1998.
Osifo 1970 {published data only}
    1. Osifo BO. The effect of folic acid and iron in the prevention of nutritional anaemias in pregnancy in Nigeria. British Journal of Nutrition 1970;24(3):689-94. - PubMed
Osrin 2005 {published data only}
    1. Adhikari R, Manandhar D, Costello A, Tompkins A, Filteau S, Osrin D, et al. The effects of antenatal multiple micronutrient supplementation on birthweight, gestation and infection: a double blind, randomised controlled trial conducted in Nepal: study protocol. MIRA Janakpur Multiple Micronutrient Supplementation 2003.
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Pandey 2015 {published data only}
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Parkkali 2013 {published data only}
    1. Hemminki E. Routine iron prophylaxis during pregnancy (PROFEG). clinicaltrials.gov (http://Clinicaltrials.gov/) (accessed 20 February 2008).
    1. Parkkali S, Abacassamo F, Nwaru BI, Salome G, Augusto O, Regushevskaya E, et al. Comparison of routine prenatal iron prophylaxis and screening and treatment for anaemia: pregnancy results and preliminary birth results from a pragmatic randomised controlled trial (PROFEG) in Maputo, Mozambique. BMJ Open 2013;3(2):001948. - PMC - PubMed
    1. Parkkali S, Abacassamo F, Salome G, Augusto O, Nikula M, on behalf of the PROFEG-group. Routine Iron Prophylaxis During Pregnancy. Effects on Maternal and Child Health in Maputo City and the Urban Part of Maputo Province, Mozambique. Report of a Pilot Study. Profeg Group, 2007.
Payne 1968 {published data only}
    1. Payne RW. Prophylaxis of anaemia in pregnancy. Journal of the Royal College of General Practitioners 1968;16:353-8. - PMC - PubMed
Peña‐Rosas 2003 {published data only}
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Picha 1975 {published data only}
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Pita Martin 1999 {published and unpublished data}
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    1. Pita Martin de Portela ML. Personal communication 22 March 2004.
Powers 1985 {published data only}
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Priliani 2019 {published data only}
    1. Priliani L, Prado EL, Restuadi R, Waturangi DE, Shankar AH, Malik SG. Maternal multiple micronutrient supplementation stabilizes mitochondrial DNA copy number in pregnant women in lombok, Indonesia. Journal of Nutrition 2019;149(8):1309-16. 13576109 [PMID: ] - PMC - PubMed
Quintero 2004 {unpublished data only}
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Rabindrakumar 2021 {published data only}
    1. Rabindrakumar MS, Wickramasinghe VP, Arambepola C, Senanayake H, Karunaratne V, Thoradeniya T. Baseline iron andlow-grade inflammation modulate the effectiveness of iron supplementation: evidence from follow-up of pregnant SriLankan women. European Journal of Nutrition 2021;60(2):1101-9. [CENTRAL: CN-02142943] [EMBASE: 2005440849] [PMID: ] - PubMed
Rae 1970 {published data only}
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Ramakrishnan 2003 {published data only}
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Ramakrishnan 2016 {published data only}
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Rayado 1997 {published data only}
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Reddaiah 1989 {published data only}
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Reddy 2016 {published data only}
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Ridwan 1996 {published and unpublished data}
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Robinson 1998 {published and unpublished data}
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Rolschau 1979 {published data only}
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Roztocil 1994 {published data only}
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Rukhsana 2006 {published data only}
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Rybo 1971 {published data only}
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Sachdeva 1993 {published data only}
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Saha 2007 {published data only}
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Salma 2021 {published data only}
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Sandstad 2003 {published data only}
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Schoorl 2012 {published data only}
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Seck 2008 {published data only}
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Shaheen 2020 {published data only}
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Shankar 2016 {published data only}
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Shatrugna 1999 {published data only}
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Sinha 2011 {published data only}
    1. Sinha V, Dayal M, Mehrotra R, Mishra V. Intravenous iron sucrose versus oral ferrous ascorbate in the prevention of anaemia in pregnant women. In: 54th All India Congress of Obstetrics and Gynaecology; 2011 January 5-9; Hyderabad, Andhra Pradesh, India. 2011:72.
Sjostedt 1977 {published data only}
    1. Sjostedt JE, Manner P, Nummi S, Ekenved G. Oral iron prophylaxis during pregnancy - a comparative study on different dosage regimens. Acta Obstetricia et Gynecologica Scandinavica 1977;66:3-9. - PubMed
Sood 1979 {published data only}
    1. Sood SK, Ramachandran K, Rani K, Ramalingaswami V, Mathan VI, Ponniah J, et al. WHO sponsored collaborative studies on nutritional anaemia in India. The effect of parenteral iron administration in the control of anaemia of pregnancy. British Journal of Nutrition 1979;42:399-406. - PubMed
Srisupandit 1983 {published data only}
    1. Srisupandit S, Pootrakul P, Areekul S, Neungton S, Mokkaves J, Kiriwat O, et al. A prophylactic supplementation of iron and folate in pregnancy. Southeast Asian Journal of Tropical Medicine and Public Health 1983;14(3):317-23. - PubMed
Steer 1992 {published data only}
    1. Steer PJ. Trial to assess the effects of iron and folate supplementation on pregnancy outcome [trial abandoned]. Personal communication 1992.
Stone 1975 {published data only}
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Suhartatik 2020 {published data only}
    1. Suhartatik, Hadju V, Muis M, Ishak H, Adriani M. The effect of moringa oleifera flour given for mothers breastfeeding against morbidity of baby ages 0-6 months in Jeneponto District. Indian Journal of Public Health Research and Development 2020;11(1):1760-5. [CENTRAL: CN-02101527] 13304745 [EMBASE: 2004100387]
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Swain 2011 {published data only}
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Tampakoudis 1996 {published data only}
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Tan 1995 {published data only}
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Tange 1993 {published data only}
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Thane‐Toe 1982 {published data only}
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Thomsen 1993 {published data only}
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Tofail 2008 {published data only}
    1. Ziaei S, Rahman A, Raqib R, Lonnerdal B, Ekstrom EC. A prenatal multiple micronutrient supplement produces higher maternal vitamin B-12 concentrations and similar folate, ferritin, and zinc concentrations as the standard 60-mg iron plus 400-μg folic acid supplement in rural Bangladeshi women. Journal of Nutrition 2016;146(12):2520-9. [CENTRAL: CN-01379296] 5792421 [PMID: ] - PMC - PubMed
Trigg 1976 {published data only}
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Vazquez 2019 {published data only}
    1. NCT03196882. Effectiveness of adaptation of the dose of iron supplementation in pregnancy on maternal-child health. (ECLIPSES) [Effectiveness of adaptation of the dose of iron supplementation in pregnancy on maternal-child health. Randomized clinical trial (ECLIPSES)]. https://clinicaltrials.gov/show/nct03196882 (first received 15 June 2017). [CENTRAL: CN-01588783] 8477326
    1. Vazquez LI, Arija V, Aranda N, Aparicio E, Serrat N, Fargas F, et al. The effectiveness of different doses of iron supplementation and the prenatal determinants of maternal iron status in pregnant Spanish women: ECLIPSES study. Nutrients 2019;11(10):2418. [CENTRAL: CN-01999289] 12300468 [EMBASE: 2002781997] [PMID: ] - PMC - PubMed
Vogel 1963 {published data only}
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Wali 2002 {published data only}
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Wasim 2023 {published data only}
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Weil 1977 {published data only}
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West 2014 {published data only}
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Willoughby 1966 {published data only}
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Willoughby 1968 {published data only}
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Winichagoon 2003 {unpublished data only}
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Wu 1998 {published data only}
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Yecta 2011 {published data only}
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Yu 1998 {published and unpublished data}
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References to studies awaiting assessment

Akyol 2014 {published data only}
    1. Akyol S, Karatas K, Tunali H. Relationship of iron supplementation during pregnancy with the opsonization and complement components. American Journal of Reproductive Immunology 2014;71(Suppl 1):31. [CENTRAL: CN-01049808] 1780397 [EMBASE: 71746637]
Alizadeh 2016 {published data only}
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Corrigan 1936 {published data only}
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CTRI/2016/10/007373 (first received 2016) {published data only}
    1. CTRI/2016/10/007373. Rasayana in pregnancy [Role of Madhuraushadha Siddha Avaleha As Garbhini Rasayana in the 6th and 7th month of pregnancy]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2016/10/007373 (first received 2016). [CENTRAL: CN-01819412] 10719340
Dixit 2023 {published data only}
    1. Dixit R, Mittal A, Singhal P, Dey S. Evaluation of the effect of iron sucrose and ferrous ascorbate for the treatment of anaemia during pregnancy: a randomised controlled trial. International Journal of Pharmaceutical and Clinical Research 2023;15(7):409‐14.
Hamzehgardeshi 2009 {published data only}
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Han 2011 {published data only}
    1. Han XX, Sun YY, Ma AG, Yang F, Zhang FZ, Jiang DC, et al. Moderate NaFeEDTA and ferrous sulfate supplementation can improve both hematologic status and oxidative stress in anemic pregnant women. Asia Pacific Journal of Clinical Nutrition 2011;20(4):514-20. - PubMed
Hankin 1963 {published data only}
    1. Hankin ME, Symonds EM. Body weight, diet and pre-eclamptic toxaemia in pregnancy. Australian & New Zealand Journal of Obstetrics & Gynaecology 1962;4:156-60.
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Jafarbegloo 2010 {published data only}
    1. IRCT138812042558N4. Effects of iron supplement on neonates anthropometric measures [The effects of iron supplement on neonates anthropometric measures in pregnant women with Hb higher than13.2 gr/dl]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT138812042558N4 2012. [CENTRAL: CN-01847864] 10747713
    1. Jafarbegloo E, Tehran HA, Tehrani TD. Gastrointestinal complications of ferrous sulfate in pregnant women: a randomized double-blind placebo-controlled trial. Iranian Red Crescent Medical Journal 2015;17(8):e15001. [CENTRAL: CN-01090072] 1820636 [EMBASE: 605750333] [PMID: ] - PMC - PubMed
    1. Jafarbegloo E. Gastrointestinal complications of iron supplement in pregnant women. IRCT Iranian Registry of Clinical Trials (www.irct.ir) (accessed 6 December 2010) 2010.
Korkmaz 2014 {published data only}
    1. Korkmaz V, Ozkaya E, Seven BY, Duzguner S, Karsli MF, Kucukozkan T. Comparison of oxidative stress in pregnancies with and without first trimester iron supplement: a randomized double-blind controlled trial. Journal of Maternal-Fetal & Neonatal Medicine 2014;27(15):1535-8. - PubMed
Liu 2000 {published data only}
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Ma 2010 {published data only}
    1. Ma AG, Schouten EG, Sun YY, Yang F, Han XX, Zhang FZ, et al. Supplementation of iron alone and combined with vitamins improves haematological status, erythrocyte membrane fluidity and oxidative stress in anaemic pregnant women. British Journal of Nutrition 2010;104(11):1655-61. - PubMed
NCT04101461 (first received 2019 Sep 24) {published data only}
    1. NCT04101461. The oral iron on the prevention of iron deficiency anemia in obese pregnant [The effectiveness of single versus double daily dose of oral iron on the prevention of iron deficiency anemia in obese pregnant women]. https://clinicaltrials.gov/show/nct04101461 (first received 24 September 2019). [CENTRAL: CN-01992155] 12184278
NCT04810546 (first received 2021 Mar 23) {published data only}
    1. NCT04810546. Feasibility or oral lactoferrin to prevent iron deficiency anemia in obese pregnancy. https://clinicaltrials.gov/show/NCT04810546 (first received 23 March 2021). [CENTRAL: CN-02253096] 17287875
NCT05423249 (first received 2022) {published data only}
    1. NCT05423249. Treatment of non-anemic iron deficiency in pregnancy [Treatment of non-anemic iron deficiency in pregnancy: a single-blind randomized control trial]. https://clinicaltrials.gov/show/NCT05423249 (first received 2022). [CENTRAL: CN-02423035] 21180798
Ouladsahebmadarek 2011 {published data only}
    1. Ouladsahebmadarek E, Sayyah-Melli M, Taghavi S, Abbasalizadeh S, Seyedhejazie M. The effect of supplemental iron elimination on pregnancy outcome. Pakistan Journal of Medical Sciences 2011;27(3):641-5.
PACTR201804003188338 (first received 2018) {published data only}
    1. PACTR201804003188338. Spatone trial in pregnant nigerian women [A randomized, 28-days, parallel-group, equivalence study to compare the effectiveness of 10mg Fe2+ Spatone Iron-Plus and 60mg Fe2+ ferrous sulphate in improving haemoglobin status of pregnant women in Lagos University Teaching Hospital]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=PACTR201804003188338 (first received 2018). [CENTRAL: CN-01904182] 10803881
Sun 2010 {published data only}
    1. Sun YY, Ma AG, Yang F, Zhang FZ, Luo YB, Jiang DC, et al. A combination of iron and retinol supplementation benefits iron status, IL-2 level and lymphocyte proliferation in anemic pregnant women. Asia Pacific Journal of Clinical Nutrition 2010;19(4):513-9. - PubMed
Ziaei 2007 {published and unpublished data}
    1. Jafarbegloo E. Gastrointestinal complications of iron supplement in pregnant women. IRCT Iranian Registry of Clinical Trials (www.irct.ir) (accessed 6 December 2010) 2010.
    1. Ziaei S, Norrozi M, Faghihzadeh S, Jafarbegloo E. A randomised placebo-controlled trial to determine the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin > or = 13.2 g/dl. BJOG 2007;114(6):684-8. - PubMed
    1. Ziaei S. Personal communication 1 October 2007.
Ziaei 2008 {published and unpublished data}
    1. Hamzehgardeshi Z. A randomized placebo-controlled trial to determine the effect of iron supplementation on hematological indices in pregnant women with hemoglobin > 13.2 g/dl. IRCT Iranian Registry of Clinical Trials (www.irct.ir) (accessed 6 December 2010) 2010.
    1. Janghorban R, Ziaei S, Faghihzade S. Evaluation of serum copper level in pregnant women with high hemoglobin. Iranian Journal of Medical Sciences 2006;31(3):170-2.
    1. Ziaei S, Janghorban R, Shariatdoust S, Faghihzadeh S. The effects of iron supplementation on serum copper and zinc levels in pregnant women with high-normal hemoglobin. International Journal of Gynaecology and Obstetrics 2008;100:133-5. - PubMed
    1. Ziaei S, Mehrnia M, Faghihzadeh S. Iron status markers in nonanemic pregnant women with and without iron supplementation. International Journal of Gynaecology and Obstetrics 2008;100:130-2. - PubMed
    1. Ziaei S. Iron status markers in non-anemic pregnant women with or without iron supplementation in pregnancy. Personal communication 9 October 2007.

References to ongoing studies

ISRCTN16425597 2023 {published data only}
    1. Prevention of anaemia with oral iron supplementation. https://trialsearch.who.int/Trial2.aspx?TrialID=ISRCTN16425597 2023.

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