~ 23 ~ International Journal of Clinical Obstetrics and Gynaecology 2021; 5(4): 23-27 ISSN (P): 2522-6614 ISSN (E): 2522-6622 © Gynaecology Journal www.gynaecologyjournal.com 2021; 5(4): 23-27 Received: 19-04-2021 Accepted: 21-06-2021 Tawaqualit Abimbola Ottun Department of Obstetrics & Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Lagos, Nigeria Fatai Oloyede Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Lagos, Nigeria Adeniyi Abiodun Adewunmi Department of Obstetrics & Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Lagos, Nigeria Faosat Olayiwola Jinadu Department of Radiology, Lagos State University Teaching Hospital, Lagos, Nigeria Ayokunle Moses Olumodeji Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Lagos, Nigeria Corresponding Author: Tawaqualit Abimbola Ottun Department of Obstetrics & Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Lagos, Nigeria Daily versus intermittent iron supplementation in pregnancy: A randomized trial Tawaqualit Abimbola Ottun, Fatai Oloyede, Adeniyi Abiodun Adewunmi, Faosat Olayiwola Jinadu and Ayokunle Moses Olumodeji DOI: https://doi.org/10.33545/gynae.2021.v5.i4a.960 Abstract WHO recommends daily oral iron supplementation for pregnant women to prevent maternal iron- deficiency anaemia however patients’ adherence to daily oral iron regimens is poor. We compared the effect of daily and intermittent oral iron supplementation on hematologic and iron indices in pregnancy and fetal outcome. This was a prospective randomized clinical trial in which 300 healthy pregnant women without anemia, in their 20th week of pregnancy were randomly allocated to receive either 600mg-ferrous sulfate tablet daily or 600mg-ferrous sulfate tablet twice weekly. Hemoglobin and serum iron indices were measured before and after the supplementation and compared. There were no significant differences between the pre- and post-intervention hemoglobin levels when the two groups were compared. Birth weights and Apgar scores of babies born to mothers in both study arms were comparable. Therefore, twice weekly iron supplementation is equally effective as daily iron supplementation for healthy pregnant women with similar fetal outcomes. Keywords: anaemia in pregnancy, hemoglobin concentration, iron supplementation, serum iron in pregnancy Introduction Maternal anaemia is a predominant problem in low-income and high-income countries with well-known adverse maternal and foetal implications [1] . This is mainly because the increased iron requirements in pregnancy, to meet increase demand of both mother and the fetus, is not met due to insufficient intake in many women in developing countries resulting in in anemia in pregnancy [2] . Because iron deficiency anaemia, the most common cause of maternal anaemia, is associated with adverse pregnancy outcomes, iron supplementation is recommended by the WHO [3, 4] . Despite widespread use of iron supplementation in pregnancy, iron-deficiency anaemia during pregnancy is still prevalent [5] . Poor compliance with iron supplementation protocols because of side-effects, especially gastrointestinal (GI) complications such as nausea, vomiting and constipation, is suggested as one of the main reasons for the inefficiency of daily iron supplementation regimens [6] . These GI side effects are probably caused by the challenges of coping with oxidative stress from large doses of iron [7] . The gut mucosal turnover rate is about 3 days. Some studies have suggested that continuous administration of oral iron impairs the absorption of a subsequent iron dose, [8] while others reported that intermittent iron supplementation may let the mucosa to heal, allow better iron absorption and reduce side effects [9, 10] . This study compared the effect of daily and twice weekly iron supplementation regimens, in non-anaemic pregnant women, on the following haematological indices: hemoglobin concentration (Hb), serum ferritin (SFT), serum iron (SFE) mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC). Materials and Methods Participants We assessed women at the antenatal clinic of Maternal and Child Centres of Isolo and Ifako General Hospitals, Lagos, Nigeria, both centres were at the time of the study run by the obstetrics and gynaecology department of the Lagos State University Teaching Hospital. Between June 2014 and June 2015, pregnant women between 18-40 years of age at 20 weeks