Evidence map›Paper›PMID 27297013›Full record

Trial reportBMJ open2016

Is selective prenatal iron prophylaxis better than routine prophylaxis: final results of a trial (PROFEG) in Maputo, Mozambique.

Elina Hemminki, Bright I Nwaru, Graca Salomé, Saara Parkkali, Fatima Abacassamo, Orvalho Augusto, Julie Cliff, Elena Regushevskaya, Martinho Dgedge, Cesar Sousa and 1 more

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IVMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00488579 (Routine Iron Prophylaxis During Pregnancy - Effects on Maternal and Child Health in Maputo City and Province), which is not on this map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00488579 phase4completednot on this map

Routine Iron Prophylaxis During Pregnancy - Effects on Maternal and Child Health in Maputo City and Province (Mozambique)

TypeinterventionalSponsorNational Istitute For Health and Welfare, FinlandRan2007 to 2016Enrolled4,326ConditionsPregnancyArmsTwo policies of iron prophylaxis
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Daily oral iron supplementation during pregnancy.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 3 countries.

Elina HemminkiHealth Services and Policy Research, National Institute for Health and Welfare, Helsinki, Finland.
Bright I NwaruCentre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, UK School of Health Sciences, University of Tampere, Tampere, Finland.
Graca SaloméMedical Faculty, Department of Physiological Sciences, Eduardo Mondlane University, Maputo, Mozambique.
Saara ParkkaliHealth Services and Policy Research, National Institute for Health and Welfare, Helsinki, Finland.
Fatima AbacassamoMedical Faculty, Department of Community Health, Eduardo Mondlane University, Maputo, Mozambique.
Orvalho AugustoMedical Faculty, Department of Community Health, Eduardo Mondlane University, Maputo, Mozambique.
Julie CliffMedical Faculty, Department of Community Health, Eduardo Mondlane University, Maputo, Mozambique.
Elena RegushevskayaHealth Services and Policy Research, National Institute for Health and Welfare, Helsinki, Finland.
Martinho DgedgeMinistry of Health, Maputo, Mozambique.
Cesar SousaMedical Faculty, Department of Community Health, Eduardo Mondlane University, Maputo, Mozambique.
Baltazar ChilundoMedical Faculty, Department of Community Health, Eduardo Mondlane University, Maputo, Mozambique.
Eduardo Mondlane University · MZFinnish Institute for Health and Welfare · FIMinistry of Health · MZTampere University · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare routine versus selective (ie, screening and treatment for anaemia) prenatal iron prophylaxis in a malaria-endemic and HIV-prevalent setting, an extended analysis including previously missing data.

designA pragmatic randomised controlled clinical trial.

setting2 health centres in Maputo, Mozambique.

participantsPregnant women (≥18 years old; non-high-risk pregnancy) were randomly allocated to routine iron (n=2184) and selective iron (n=2142) groups.

interventionsIn the routine group, women received 60 mg ferrous sulfate plus 400 μg folic acid daily. In the selective group, women received 1 mg of folic acid daily and haemoglobin (Hb) screening at each visit; with low Hb (cut-off 9 g/dL) treatment (120 mg+800 μg of folic acid daily) for a month. OUTCOME MEASURES: PRIMARY OUTCOMES: preterm birth, low birth weight; secondary outcomes: self-reported malaria, labour complications, caesarean section, perinatal death, woman's death. Nurses collected pregnancy data. Birth data were abstracted from hospital records for 52% of women and traced using various methods and linked with probabilistic matching for 24%. Women's deaths were collected from death registers.

resultsBirth data were available for 3301 (76%) of the women. Outcomes were similar in the two groups: preterm births (27.1% in the selective vs 25.3% in the routine group), low birthweight infants (11.0% vs 11.7%), perinatal deaths (2.4% vs 2.4%) and caesarean sections (4.0% vs 4.5%). Women's deaths during pregnancy or <42 days postpartum were more common in the selective group (0.8% among the two best matched women) than in the routine group (0.4%). Extra deaths could not be explained by the cause of death, Hb level or HIV status at recruitment.

conclusionsBirth outcomes were similar in the two iron groups. There might have been more women's deaths in the selective iron group, but it is unclear whether this was due to the intervention, other factors or chance finding. TRIAL REGISTRATION NUMBER: NCT00488579.

Indexed as

AdultAnemia, Iron-DeficiencyCesarean SectionDietary SupplementsFemaleFerrous CompoundsFolic AcidHemoglobinsHIV InfectionsHumansInfantInfant, Low Birth WeightInfant, NewbornIronMalariaMaternal DeathFerrous Compoundsferrous sulfateFolic AcidHemoglobinsIronbirthiron supplementationmalariapragmatic trialpregnancy

Identifiers

PMID27297013
PMCPMC4916582
OpenAlexW2425860421

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.