Daily iron and folic acid supplementation during pregnancy
Intervention | Last updated: 26 July 2024
It is estimated that more than 40% of pregnant women worldwide are anaemic. At least half of this anaemia burden is assumed to be due to iron deficiency.
Pregnant women require additional iron and folic acid to meet their own nutritional needs as well as those of the developing fetus. Deficiencies in iron and folic acid during pregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development.
Evidence has shown that the use of iron and folic acid supplements is associated with a reduced risk of iron deficiency and anaemia in pregnant women.
WHO Recommendations
Daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron* and 400 µg (0.4 mg) folic acid** is recommended for pregnant women to prevent maternal anaemia, puerperal sepsis, low birth weight, and preterm birth.***
*The equivalent of 60 mg of elemental iron is 300 mg ferrous sulfate heptahydrate, 180 mg ferrous fumarate or 500 mg of ferrous gluconate.
** Folic acid should be commenced as early as possible (ideally before conception) to prevent neural tube defects.
*** This recommendation supercedes the previous recommendation found within the WHO guideline ‘Daily iron and folic acid supplementation in pregnant women’ (2012).
Guidelines and guidance documents Learn More
GRC-approved guidelines
Evidence
Systematic reviews used to develop the guidelines
Daily oral iron supplementation during pregnancy
Peña-Rosas JP, De-Regil LM, Garcia-Casal MN, Dowswell T. Cochrane Database of Systematic Reviews. 2015; Issue 7. Art. No.: CD004736.
Summary of this reviewRelated systematic reviews
Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, et al. Am J Clin Nutr. 2016;103(2):495-504.
Routine iron/folate supplementation during pregnancy: effect on maternal anaemia and birth outcomes
Imdad A, Bhutta ZA. Paediatric and Perinatal Epidemiology. 2012; 26:168–177.
Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. BMJ. 2013; 346:f3443.
Cost-effectiveness Learn More
Cost-effectiveness analyses
Svefors P, Selling KE, Shaheen R, Khan AI, Persson LÅ, Lindholm L.PLoS One. 2018; 13(2):e0191260.
Shaheen R, Persson LÅ, Ahmed S, Streatfield PK, Lindholm L.BMC Pregnancy Childbirth. 2015; 15:125.
Baltussen R, Knai C, Sharan M.J Nutr. 2004; 134(10):2678-84.
Category 1 intervention
Guidelines have been recently approved by the WHO Guidelines Review Committee
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Essential Nutrition Actions
This intervention is an Essential Nutrition Action targeting the first 1000 days of life.
