Fewer iron supplements during pregnancy work just as well for preventing anemia, study suggests

ScienceDaily (July 11, 2012) — Taking iron supplements one to three times a week instead of every day is just as effective at preventing anemia in pregnant women, according to the findings of a new Cochrane systematic review. The authors of the review also showed that women experienced fewer side effects when taking iron supplements intermittently rather than daily.

See Also:Health & MedicineAnemiaPregnancy and ChildbirthFolic AcidSickle Cell AnemiaNutritionDiet and Weight LossReferenceNutrition and pregnancyB vitaminsMicronutrientGynecologic hemorrhage

Lack of iron can cause anemia in pregnant women, potentially increasing the risk of complications at delivery. It may also be harmful to their babies, through increased risk of low birth weight and even delayed growth and development later in life. anemia is diagnosed as a low level of hemoglobin in the blood. However, hemoglobin levels should be carefully controlled during pregnancy, as high concentrations have also been associated with an increased risk of babies being born early or with low birthweight. Traditionally, anemia during pregnancy is prevented by daily supplements containing iron and folic acid, started as early in the pregnancy as possible. However, some countries, such as the UK, do not recommend routine preventive iron supplementation to all women.

The researchers analysed data from 18 trials involving a total of 4,072 pregnant women who took iron supplements alone, with folic acid or with multi-vitamin and mineral supplements. According to the results, women who took iron supplements once, twice or three times a week on non-consecutive days were no more likely to suffer from anemia by the end of their pregnancies than those who took them daily, and their babies were no more likely to be born early or have a low birth weight. Furthermore, those taking the supplements intermittently rather than daily were less likely to experience side effects including nausea, constipation and high hemoglobin levels during pregnancy.

"Intermittent iron supplementation could be considered as a feasible alternative to daily supplementation for preventing anemia during pregnancy, particularly in developed countries where anemia in pregnancy is not a public health problem and there is good antenatal care for monitoring anemia status," said lead author Juan Pablo Peña-Rosas, Coordinator of Evidence and Programme Guidance of the Department of Nutrition for Health and Development at the World Health Organization in Geneva, Switzerland. "At the moment evidence is limited and the quality of the trials included in our review was generally low."

The review authors say further research is needed to clarify safe maternal iron doses and their effects on infants. "It is important to evaluate new regimens to be able to respond to the need of the different countries that face different challenges in anemia prevention during pregnancy. We would advise that trials make an effort to evaluate the health of newborns and infants from birth to six months of life or more," said Peña-Rosas.

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American Kids Getting Fewer Prescription Drugs: Study

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) -- New research shows that the number of prescriptions written for children has dropped by 7 percent in recent years.

Between 2002 and 2010, notable decreases occurred in antibiotic, cough/cold, allergy, pain and depression prescriptions, according to the study, which was conducted by the U.S. Food and Drug Administration. At the same time, there was a rise in the number of asthma, attention-deficit hyperactivity disorder (ADHD) and contraceptive prescriptions.

"Approximately 263 million prescriptions were dispensed to the pediatric population in 2010 -- 7 percent lower than the number of prescriptions dispensed in 2002," the study authors said, adding that the number of prescriptions written for children dropped by 2.4 million each year between 2002 and 2010.

During that time, however, the number of prescriptions written for adults increased by 22 percent, according to the study.

The findings were released online June 18 and are scheduled to appear in the July print edition of the journal Pediatrics.

The top 10 prescribed drugs for children 17 and under in 2010 included antibiotics, asthma medications and the pain reliever ibuprofen. Antibiotics accounted for approximately one-quarter of all prescriptions written between 2002 and 2010, according to the study.

By 2010, however, the number of antibiotic prescriptions had decreased by 14 percent.

"This could potentially be good news. The antibiotic numbers are consistent with the efforts to decrease the use of antibiotics for upper respiratory infections," said Dr. Kenneth Bromberg, chairman of pediatrics at the Brooklyn Hospital Center in New York City.

He noted, however, that this particular study wasn't designed to tease out the reasons behind a change in medication use, only to determine whether a change occurred.

Still, he said, "It's likely that this represents some of the efforts to cut down on antibiotic use, and this will help to decrease the risk of antibiotic resistance."

The volume of allergy-medication prescriptions also decreased significantly (61 percent), but much of that decrease may be because many allergy medications went from prescription-only to being available over the counter during the study period.

The number of prescriptions written for cough and cold medication dropped by 42 percent during the study. The authors suggest that this may be due to a public-health advisory in 2008 that warned against using such medications in children under 2.

Prescriptions for pain medications declined by 14 percent, and the number of prescriptions for depression drugs dropped by 5 percent.

Dr. Victor Fornari, director of the division of child and adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y., said the decrease in depression-medication prescriptions may have something to do with the black box warnings that were added to the drugs, which described an increased risk of suicide.

Not all classes of medications were prescribed less often. The number of prescriptions for ADHD medications increased by 46 percent, according to the study. Part of that increase likely is due to an increase in the number of children being diagnosed with ADHD. In 2002, 4.4 million children were estimated to have the disorder. By 2010, that number was 5 million, according to the study.

Even with the increase in prescriptions, Fornari said ADHD still is being underdiagnosed and undertreated.

"With medication, the outcomes can be dramatic improvement in school performance and behavior," he said.

Another class of medications for which prescriptions increased dramatically was contraceptives. The number of prescriptions written increased by 93 percent, according to the study. The authors pointed out, however, that other research, done by the U.S. Centers for Disease Control and Prevention, hasn't shown an increase in the use of birth control pills.

Bromberg said one possible explanation for this disparity stems from the study itself. The researchers looked for the number of prescriptions written, not how many individuals received a prescription. So it may be that females on birth control are staying on the drug for longer periods of time, which would increase the number of prescriptions written.

The study also found that the number of prescriptions for asthma medications increased by 14 percent. The authors didn't theorize as to what might be behind this increase.

More information

Learn about safely giving children medication from the Nemours Foundation.

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More ADHD drugs, fewer antibiotics for US kids: study

"A pediatrician performs a check-up on a child at the University of Miami Pediatric clinic in 2007 in Miami, Florida. More drugs for attention deficit hyperactivity disorder and fewer antibiotics are being prescribed to US children and teenagers compared to a decade ago. (AFP Photo/Joe Raedle)" title

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Fewer Medicare Patients Being 'Admitted' to Hospitals: Study

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Fewer Stillbirths Among Pregnant Women Vaccinated Against Flu

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Fewer Young Americans Smoking, Survey Finds

HealthDay – 45 mins ago THURSDAY, May 17 (HealthDay News) -- Smoking rates among American teens and young adults fell between 2004 and 2010, but too many of them still light up, a new federal government report reveals.

The rate of current cigarette use among U.S. teens decreased from nearly 12 percent in 2004 to about 8 percent in 2010, and dropped from nearly 40 percent to about 34 percent among young adults, according to the analysis from the Substance Abuse and Mental Health Services Administration's National Survey on Drug Use and Health released Thursday.

The percentage of daily smokers among teens fell from just over 3 percent to under 2 percent, and decreased from about 20 percent to nearly 16 percent among young adults during the study period, the survey found.

Among young adults who were daily smokers, the percentage who smoked 26 or more cigarettes a day (about 1

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Fewer children die in accidents; drug overdoses up

Accidents are killing far fewer children and teenagers than in the past, according to a new government report released Monday.

The death rate for youths ages 19 and younger dropped about 30 percent from 2000 to 2009. The number of deaths dropped too, from about 12,400 to about 9,100.

"We've made progress, and because we've made progress our children are safer than ever before," said Ileana Arias of the Centers for Disease Control and Prevention, the agency that released the report.

But accidental injuries remain the leading cause of death for youths ages 1 to 19. On average, one child dies every hour from fires, falls and other accidents, she added.

A 41 percent drop in traffic fatalities had a huge impact on the numbers

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US doctors urge fewer tests, less costly treatments

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Fewer U.S. Med Students Choose Psychiatry: Report

HealthDay – 1 hr 17 mins ago FRIDAY, March 30 (HealthDay News) -- The declining number of U.S. medical students who choose psychiatry as a specialty is cause for concern because there's already a shortage of psychiatrists, experts warn.

The overall downward trend has occurred for the past six years, according to a National Resident Matching Program report.

Medical schools need to provide more information and training to medical school students so they know psychiatry can be a profitable and rewarding career, the American Psychiatric Association (APA) said.

"In 2010, there was a slight increase in the number of seniors choosing psychiatry, but overall the trend has been downward," APA president Dr. John Oldham said in an association news release.

"We need to reach out to medical students in more effective ways than simply exposing them to a four-week clerkship on an inpatient unit, with no follow-up of the patients they have cared for," Oldham said. "Establishing and maintaining ongoing relationships with patients is one of the key factors that makes psychiatry such a fulfilling career."

Psychiatrists specialize in diagnosing, treating and preventing mental illness, including substance-abuse disorders.

The reasons for the decline in students choosing to pursue a career in psychiatry aren't well known, but there could be several factors, said Dr. James Scully Jr., the APA's medical director and CEO.

"This is a very exciting time for psychiatry, when we have more scientific developments in the field than ever before, but this means that the field is evolving in ways in which the outcome is unknown," Scully said in the news release. "It's a great time for young doctors to have an impact on what the future of psychiatry will look like."

There are about 50,000 psychiatrists in the United States -- too few to serve all the patients who need help, especially in rural areas, according to the APA. The group also noted that about half of currently practicing psychiatrists are over the age of 55, and many will soon retire.

More information

The American Psychiatric Association has more about being a psychiatrist.

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