Evidence map›Paper›PMID 39834271›Full record

SynthesisFamily practice2025

The benefits and harms of oral iron supplementation in non-anaemic pregnant women: a systematic review and meta-analysis.

Archie Watt, Holden Eaton, Kate Eastwick-Jones, Elizabeth T Thomas, Annette Plüddemann

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

5 authors.

Archie WattOxford Medical School, Medical Sciences Division Office, Level 3 Academic Centre, John Radcliffe Hospital, Headington, Oxford OX3 9DU, United Kingdom.ORCID 0000-0002-7572-4586
Holden EatonOxford Medical School, Medical Sciences Division Office, Level 3 Academic Centre, John Radcliffe Hospital, Headington, Oxford OX3 9DU, United Kingdom.ORCID 0009-0005-9779-1017
Kate Eastwick-JonesOxford Medical School, Medical Sciences Division Office, Level 3 Academic Centre, John Radcliffe Hospital, Headington, Oxford OX3 9DU, United Kingdom.ORCID 0000-0003-4162-201X
Elizabeth T ThomasNuffield Department of Primary Care Health Sciences, Centre for Evidence Based Medicine, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom.ORCID 0000-0001-7008-8763
Annette PlüddemannNuffield Department of Primary Care Health Sciences, Centre for Evidence Based Medicine, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom.ORCID 0000-0003-2101-0390

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIron deficiency during pregnancy poses a significant risk to both maternal and foetal health. Current international guidelines provide discrepant advice on antenatal iron supplementation for non-anaemic women.

objectiveWe aimed to quantify the benefits and harms of routine antenatal supplementation in non-anaemic women.

methodsThe Cochrane Library, MEDLINE, Embase, and clinical trial registries were searched for randomized controlled trials and observational studies comparing oral iron supplementation with placebo or no supplement in non-anaemic pregnant women. Risk of bias was assessed for each study and the results were synthesized via meta-analysis.

resultsTwenty-three eligible studies were identified with 4492 non-anaemic pregnant women. Supplemented groups had higher haemoglobin [mean difference = 6.95 g/l, 95% confidence interval (CI): 4.81-9.09, P < .001, moderate certainty, I2 = 91%] and ferritin (mean difference = 12.22 ng/ml, 95% CI: 6.92-17.52, P < .001, moderate certainty, I2 = 87%) and were at lower risk of anaemia (relative risk = 0.50, 95% CI: 0.34-0.74, P < .001, high certainty, I2 = 42%, number needed to treat (NNT) = 10). There was no difference in birth weight, preterm birth, and rate of caesarean section. Reporting on harms was inconsistent and there was insufficient evidence to determine an association between iron supplements and any negative outcome. DISCUSSION: Prophylactic iron supplementation likely results in a large reduction in maternal anaemia during pregnancy. Future research should qualify the impact of this benefit on women's quality of life and determine which subpopulations benefit most. Evidence surrounding the harms of iron supplementation in the non-anaemic population is poor quality and inconsistent. Randomized controlled trials quantifying the risk of gastrointestinal (GI) disturbance and iron overload are essential to inform iron supplement use and reduce unwarranted variations in international guidelines.

Indexed as

Dietary SupplementsIronAdministration, OralAnemia, Iron-DeficiencyFemaleHumansPregnancyPrenatal CareIronanaemiacareironiron deficienciespregnancyprenatal

Identifiers

PMID39834271
PMCPMC11747145

What OpenQuestion holds

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Registered trials

None linked

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.