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Routine Iron Prophylaxis during Pregnancy

Effects on Maternal and Child Health in Maputo City and the urban part of Maputo Province Mozambique (PROFEG). Report of the pilot study August 2007

Parkkali, Saara; Abacassamo, Fátima; Salomé, Graca; Augusto, Orvalho; Nikula, Minna; PROFEG-group

English abstract

English abstract

Background

This report gives the basic results of the pilot study from a trial "Routine Iron Prophylaxis during Pregnancy - Effects on Maternal and Child Health in Maputo, Mozambique". The objective of the trial is to compare two iron administration policies during pregnancy in regard to health and program feasibility, routine iron prophylaxis vs. screening of anaemia and therapy with iron in areas with endemic malaria and high prevalence of HIV infection. The influence of iron prophylaxis on pregnancy outcomes in developing countries remains unclear.

Subjects and Methods

The study is a pragmatic, non-blind randomised controlled trial. Women are randomised individually into two different study groups, routine and screening therapy. The pilot study was carried out between November 2006 and April 2007 in Maputo city in the health centre of 1o de Maio, with the objective to test the study procedures and the data collection process. Total of 781 women were recruited on their first antenatal visit and by April 2007, 134 women were followed up until delivery. Women were randomised into the study groups, recruited, and data collected by trained study nurses. Women in the routine group received iron prophylaxis as usual in antenatal care and the therapy group received iron therapy, if the haemoglobin measurement was below 9g/dl.

Results

We collected the data of the women on recruitment, on subsequent visits and after delivery. The average number of women recruited per week was 43 women. The foremost areas of residence of the women were Maxaquene (53%) and Polana Canhico (39%). The mean age of the participants was 24 years. Anaemia prevalence (Hb 9g/dl) in the therapy group was 36%. The deliveries (n = 134) occurred in the health centre of 1o de Maio and in Mavalane hospital, deliveries in the central hospital were not traced in the pilot.

The setting up of the pilot study was time consuming and administrative issues and authorisations took longer than expected. Several practical obstacles had to be solved. The main procedures were not modified, but data collection forms were modified slightly.