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Iron-Folic Acid Supplementation for Anemic Pregnant Women

The anemia prevalence among pregnant women in Indonesia as well as whole world remains high despite the implementation of Iron-Folic Acid (IFA) supplementation programs. Anemia in pregnant women results in bleeding during childbirth and is a principal cause of maternal mortality in Indonesia1.

Given that the occurrence of anemia among pregnant women in Indonesia has been difficult to moderate, anemia prevention and control is considered a public health priority. The Indonesian government is trying to reduce the incidence of anemia and ensure that pregnant women have sufficient iron intake. Efforts to control anemia in pregnant women include long-term programs aimed at changing dietary patterns to improve nutrition and short- term programs involving IFA supplementation2.

It has been reported that the low compliance with IFA consumption is largely due to its negative side effects (nausea, stomach pain, constipation) that present sooner and more apparently than the positive effects which are increased hemoglobin and iron levels in the body and fetus. In the same context a new study was conducted to investigate the low compliance with IFA supplementation in pregnant mothers with anemia in Indonesia and associated negative side effects3.

Based on the study results it was observed that anemia diagnoses based on clinical symptoms do not show consistent hemoglobin levels, clinical symptoms alone cannot be used as standard diagnostic criteria. After the 8 weeks supplementation period, a significant reduction in clinical symptoms and subjective complaints was observed in both treatment groups.

This indicated that the short-term IFA treatment can effectively improve these indices of anemia among pregnant women. With proper counseling on good IFA supplementation practices (e.g., before going to sleep at night), side effects, such as nausea and vomiting, dizziness, weakness and numbness, that are common in pregnant women were significantly reduced.

In the end it can be established that daily and weekly short-term IFA supplementation accompanied by monitored consumption effectively improved HB levels in pregnant women with mild anemia. However, an extended interventional period will likely give different results. The IFA supplementation herein also improved clinical symptoms and subjective complaints associated with anemia.

Weekly IFA supplementation should be considered for pregnant women with mild anemia in areas with a limited supply of IFA tablets. Further research is needed to determine the change in transferrin saturation and ferritin in order to obtain a more accurate iron status, as well as to examine the efficacy of interventional frequency, different dietary nutrient composition and longer supplementation periods.

American Journal of Food Technology


Anemia, weekly IFA supplementation, pregnant women, dietary nutrients, iron deficiency, transferrin saturation, ferritin, interventional frequency, clinical symptoms, iron intake.


  1. MOH., 2016. Health profile 2015. Ministry of Health, Indonesia.
  2. Cox, J.T. and S.T. Phelan, 2008. Nutrition during pregnancy. Obstet. Gynecol. Clin. North Am., 35: 369-393.
  3. Diah M. U., Endang L. A., Siti A. P. and Salimar, 2017. Impact of Weekly Versus Daily Iron-folic Acid Supplementation for Pregnant Women with Anemia on Hemoglobin Levels, Clinical Symptoms and Subjective Complaints. Pak. J. Nutr., 16: 463-469.

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