PURPOSE: to evaluate the impact of supplementary ferrous sulfate and dietary counseling on hemoglobin levels in pregnant women. METHODS: a total of 197 pregnant women were evaluated during antenatal care at a health center. The treatment group consisted of 105 women who were prescribed 60 mg dietary iron per day, received dietary counseling and had hemoglobin measured by a portable photometer between the 14th and 20th week of pregnancy. The treatment group was reevaluated according to hemoglobin levels and food intake by a semiquantitative food frequency questionnaire after the 34th week of pregnancy. The control group consisted of 92 women in a cross-sectional study, at no less than 34 weeks of pregnancy. Hemoglobin was analyzed by a portable photometer and anemia was defined concentrations of less than 11 g/dL. All pregnant women had their weight and height measured. Hierarchical logistic regression model was developed for the multivariate analysis. RESULTS: prevalence of anemia at the end of the third trimester was 31.6% in the treatment group and 26.1% in the control group (p=0.43). Use of the prescribed supplement was reported by 65% of women in the treatment group, of which 67.7% interrupted the treatment at some point. Principal reasons for interrupting treatment were forgetting (43.2%) and nausea or vomiting (27.2%). Risk of anemia in the third trimester was three times higher in women with less than 8 years of schooling. CONCLUSIONS: use of ferrous sulfate was not shown to be associated with lower prevalence of anemia. The results suggest that structural changes in socioeconomic conditions are needed in order to alter the current situation regarding iron deficiency anemia.
Pregnancy; Anemia; Ferrous sulfate; Supplementary feeding; Hemoglobins; Educational status; Treatment outcome
