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Abstract Anemia in pregnancy is a decrease in the total red blood cells (RBCs) or hemoglobin<11gm/dl in the blood during pregnancy or in the period following pregnancy. It involves a reduction in the oxygen carrying capacity of the blood. Anemia is an extremely common condition in pregnancy and postpartum world-wide, conferring a number of health risks to mother and child. Maternal signs and symptoms are usually non-specific, but can include: fatigue, pallor, dyspnea, palpitations and dizziness. There are numerous well-known maternal consequences of anemia including: maternal cardiovascular strain, reduced physical and mental performance, reduced peripartum blood reserves, increased risk for peripartum blood product transfusion, and increased risk for maternal mortality. The most frequent cause of anemia in pregnancy worldwide is iron deficiency anemia (IDA). Iron is needed for many physiological processes in the body, and observational studies indicate that iron deficiency during pregnancy may independently result in cognitive or behavioral abnormalities in the child. Babies of women with IDA have an increased risk of being low birth weight, being born prematurely, being more susceptible to infections, and suffering death in utero. During pregnancy, the average total iron requirement is about 30 to 60 mg of elemental iron per day for a 55 kg woman. This iron is used for the increase in red cell mass, placental needs and fetal growth. About 40% of women start their pregnancy with low to absent iron stores and up to 90% have iron stores insufficient to meet the increased iron requirements during pregnancy and the postpartum period. WHO recommends an intermittent regimen (e.g. weekly 120 mg of elemental iron and 2.8 mg of folate) for non-anemic pregnant women in communities where the prevalence of anemia is < 20%, as an effective alternative to a daily regimen for prevention of anemia during pregnancy. It is thought that an intestinal epithelial cell becomes saturated with a single oral dose of iron, resulting in reduced iron absorption as intestinal cell turnover occurs every five to six days, if oral supplements are administered weekly, new intestinal epithelial cells would be exposed to each subsequent dose, resulting in improved iron absorption. Weekly supplements have been shown to produce similar maternal and infant outcomes as daily supplements of HB and to reduce the risk of the undesirable high levels of hemoglobin mid and late pregnancy. Intermittent oral iron supplementation may also reduce peroxidase and free radical mediated oxidative stress that damages the intestinal mucosa resulting in the unpleasant gastrointestinal side effects associated with daily oral iron supplements. Therefore, weekly regimens may be more acceptable to women and therefore increase their compliance. |