Does iron supplementation make a difference?

This report attempts to answer the question through data collected from journal articles from 1966 through 1989. All data are drawn from studies of pregnant women attending prenatal clinics, including those in both developing and developed countries. The studies demonstrate that iron supplementation is efficacious and associated with initial hematologic status, dose, and duration of supplementation. In addition, the effects of iron supplementation on improving maternal hematologic status are shown to improve in the presence of folate or vitamin C supplementation. No consistent effects on birthweight have been observed. The effectiveness of iron supplementation programs, however, has been equivocal; the presence of global maternal anemia remains virtually unchanged in the past thirty year even in the presence of iron supplementation programs. Innovative approaches, including prolonged iron supplementation, investment in fortification, promotion and education of iron supplements, and resolution of logistical problems that hinder availability of iron supplements at the community level, need to be tested through both clinic- and community-based research to find effective answers to this worldwide problem. (Author abstract)