Factors Affecting Compliance with Oral Iron Supplementation in Pregnancy: Study provides insight

Recent research paper titled "The Experience of Anaemia and Ingesting Oral Iron Supplementation in Pregnancy: A Qualitative Study" aimed to understand the experience of iron deficiency anaemia (IDA) and oral iron supplementation among pregnant women. The study explored the factors affecting compliance with oral iron supplementation and the awareness of potential consequences of untreated anaemia.

The study conducted 14 semi-structured one-to-one interviews with pregnant or recently pregnant women. Key findings included the following:

1. Fatigue was a predominant and troubling symptom experienced by women with IDA, and awareness of potential consequences of untreated anaemia was limited.

Factors Affecting Compliance:

2. Gastro-intestinal side-effects, previous poor tolerance, and forgetfulness negatively impacted compliance with oral iron supplementation, while routine and perceived improvement in fatigue positively affected compliance.

Knowledge of Iron-rich Foods:

3. Knowledge of iron-rich foods and absorption aids and inhibitors was generally good, but practice on optimal ingestion of oral iron supplementation varied.

Pregnancy as a Motivating Factor:

4. Pregnancy served as a motivating factor for compliance, with women being highly motivated to do whatever necessary to ensure the best possible outcome for themselves and their baby, including taking iron supplements.

Acceptability of the Proposed Trial:

The study also explored the acceptability of a proposed randomized controlled trial of daily versus alternate day oral iron for the treatment of confirmed iron deficiency anaemia in pregnancy. Feedback on trial acceptability was generally positive, and the proposed trial was considered important and educational for women in the longer term.

Study Conclusion:

The study concluded by recognizing the significance of informing women about the important maternal and infant complications associated with iron deficiency, as it may help improve compliance with oral iron treatment. The authors emphasized the need for antenatal education on the potential consequences of anaemia to aid in improving the rates of this widespread public health issue.

The qualitative study shed light on the experiences and perceptions of pregnant women regarding IDA and oral iron supplementation. The findings provide valuable insights into the challenges and motivations related to compliance with oral iron supplementation during pregnancy, and highlight the importance of educating women about the potential consequences of untreated anaemia. The study also explored the acceptability of a proposed clinical trial, offering a comprehensive understanding of the factors influencing engagement and compliance in research studies related to maternal health.

Key Points -

1. The study found that fatigue was a predominant and troubling symptom for pregnant women with iron deficiency anaemia (IDA), and there was limited awareness of the potential consequences of untreated anaemia.

2. Factors affecting compliance with oral iron supplementation included gastro-intestinal side-effects, previous poor tolerance, and forgetfulness, which negatively impacted compliance, while routine and perceived improvement in fatigue positively affected compliance.

3. The study highlighted that while knowledge of iron-rich foods and absorption aids and inhibitors was generally good among pregnant women, actual practice regarding optimal ingestion of oral iron supplementation varied. Additionally, pregnancy served as a motivating factor for compliance, as women were highly motivated to ensure the best possible outcome for themselves and their baby, including taking iron supplements.

Reference-

O'Toole FE, Hokey E, McAuliffe FM, Walsh JM. The Experience of Anaemia and Ingesting Oral Iron Supplementation in Pregnancy: A Qualitative Study. Eur J Obstet Gynecol Reprod Biol. 2024 Jun;297:111-119. doi: 10.1016/j.ejogrb.2024.03.005. Epub 2024 Mar 26. PMID: 38608353.