Sood S K, Ramachandran K, Mathur M, Gupta K, Ramalingaswamy V, Swarnabai C, Ponniah J, Mathan V I, Baker S J
Q J Med. 1975 Apr;44(174):241-58.
A W.H.O. sponsored collaborative study of the effects of iron supplementation to pregnant women was carried out in Delhi (northern India) and Vellore (southern India). Supplementation was given under supervision from the 26th to the 36th or 38th week of pregnancy. A control group received only placebo; one group received vitamin B12 and folic acid alone; four groups received vitamin B12, folate and a daily iron supplement ranging from 30 to 240 mg of elemental iron as ferrous fumerate, and one further group received 120 mg of iron without B12 or folate. Groups receiving no iron showed a fall in mean stet concentration. Those receiving iron showed a rise in haemoglobin, the best results being in the groups receiving 120 and 240 mg of iron together with vitamin B12 and folate. Even in these groups however there was still a high prevalence of anaemia and iron deficiency at the end of the trial period. Iron alone did not produce as good results as iron plus vitamin B12 and folate. The supplementation had no detectable effect on the birth weight of the children, nor on the haemoglobin concentration of the infants at three months of age. The daily absorption of iron in the pregnant women, as judged from the increase in haemoglobin mass, was not as satisfactory as expected. Possible reasons for this are discussed. It is concluded that to provide these women with adequate iron a daily oral supplementation of 120 mg of elemental iron or more is needed. This can only be achieved by medicinal means. Before supplementation can be recommended on a public health scale, further information regarding the cost and expected benefits of such measures must be obtained.
世界卫生组织发起了一项关于孕妇补铁效果的合作研究，该研究在德里（印度北部）和韦洛尔（印度南部）开展。在怀孕第26周到第36周或第38周期间，补铁在监督下进行。一个对照组只接受安慰剂；一组只接受维生素B12和叶酸；四组接受维生素B12、叶酸以及每日30至240毫克元素铁（以富马酸亚铁形式）的铁补充剂，另有一组接受120毫克不含B12或叶酸的铁。未接受铁补充的组平均血红蛋白浓度下降。接受铁补充的组血红蛋白上升，效果最好的是同时接受120毫克和240毫克铁以及维生素B12和叶酸的组。然而，即使在这些组中，试验期结束时贫血和缺铁的患病率仍然很高。单独补铁的效果不如铁与维生素B12和叶酸联合使用的效果好。补铁对儿童出生体重以及三个月大婴儿的血红蛋白浓度没有可检测到的影响。从血红蛋白量的增加判断，孕妇每日铁的吸收情况不如预期。文中讨论了可能的原因。结论是，要为这些妇女提供足够的铁，每天需要口服120毫克或更多的元素铁。这只能通过药物手段实现。在能够在公共卫生层面推荐补铁措施之前，必须获取关于此类措施的成本和预期效益的更多信息。
