| dc.description.abstract | Anaemia during pregnancy as a result of iron and folate deficiencies is a major
threat to women, particularly in developing countries. Because of the extra
demands that pregnancy imposes on iron and folate status of the mother, and
because of the traumatic effects of such deficiencies, WHO recommends
supplementation of these micronutrients. This study evaluated the effects of iron
and folate supplementation in 100 healthy, pregnant outpatients of the Kikuyu
Hospital outside Nairobi. The subjects were similar with respect to ethnicity and
socioeconomic factors.
Subjects were divided into 4 groups in a randomized, double-blind trial. Group
A received a placebo, group B a combination of 150 mg. iron and 0.5 mg. folate,
group C folate only and group D iron only. Supplements were given in slowrelease
capsules. Participants were non-anaemic (Hb > 10 gjdl) and 25-30 weeks
pregnant on enrolment. Treatments were given for a minimum of 4 weeks before
delivery and patients were also encouraged to continue taking the capsules until
4 weeks post-partum.
Haematological indices of haemoglobin (Hb), haematocrit (Hct), mean
corpuscular volume (MeV), mean corpuscular haemoglobin (MCH), mean
corpuscular haemoglobin concentration (MCHC), erythrocyte morphology, as well
as birthweights and neonatal weight gain were used to evaluate the effects of the
supplementation. The higher than expected attrition rate may be due to reasons
of fees payable at the hospital, distances for some patients to travel and perhaps
iv
choosing to deliver elsewhere at the last minute. At the time of enrolment, 27%
of the women showed macrocytosis. Diet had no association with initial Hb or
the change in Hb during the study. However, 52% of women who showed initial
macrocytosis were consuming a diet poor in iron and folate.
The average birthweight was 3178 grams. None of the treatments had any
association with birthweights. The two factors that affected birthweights were
mothers' initial weight at the time of enrolment and mothers' weight gain during
the last trimester.
Folate supplementation had no significant effect on parameters tested. When
age, parity, height, diet and socioeconomic factors were adjusted for, only the
group receiving iron alone showed a significant rise in Hct and Hb (p < 0.005).
Iron is an essential supplement during pregnancy in most communities. The
highland population of Kenya generally have a diet rich in iron and folate
compared with many other African peoples. As a consequence, pregnancy
anaemia may not be a major public health problem in this population. Although
the results of this study support the routine supplementation with iron during
pregnancy in this highland population, the benefit of additional folate was not
clear and further studies evaluating iron and folate status during pregnancy and
possible influencing factors in this region are recommended. | en |
