Combined iron and zinc supplementation improves haematologic status of pregnant women in Upper West Region of Ghana

Abstract

Background: Though pregnant women in Ghana routinely receive iron and folic acid supplements, the prevalence of anaemia continues to be as high as 70%.

Objective: To determine the impact of zinc deficiency on iron status indicators in pregnant women.

Design: A double-blind, randomized controlled trial (RCT) of joint iron and zinc supplementation.

Setting: The study was conducted in the Upper West Region of Ghana, where the prevalence of anaemia is high.

Participants: The study population comprised pregnant women who presented themselves for antenatal care (ANC) in the Wa Regional Hospital of the Upper West Region in Ghana.

Interventions: The intervention group received a combined supplement of 40 mg zinc as zinc gluconate and 40 mg iron as ferrous sulphate. The control group received 40 mg elemental iron as ferrous sulphate.

Main outcome measures: The primary outcome measures were mean and percentage changes in Hb. Serum ferritin and zinc concentrations serve as secondary outcomes.

Results: Adjusted mean Hb increase was 0.6g/dl higher among women who were not iron replete (SF ferritin ≤ 20 µg/L) and received the iron-zinc supplement, compared to women who received iron-only supplement, F (1, 99) = 4.356, p = 0.039. Women who had low plasma zinc levels were 3-fold increased odds of developing iron deficiency at recruitment, (OR 3.41, 95% CI: 1.19-9.76).

Conclusions: Iron-zinc supplementation was effective in raising Hb and serum ferritin values among women who were iron deficient in early pregnancy but not among iron sufficient women.

Keywords: Ghana; Iron-zinc supplementation; iron-deficiency anaemia; plasma zinc; serum ferritin concentrations.