The Effects of Maternal Iron and Folate Supplementation on Pregnancy and Infant Outcomes in Africa: A Systematic Review

Yibeltal Bekele (), Claire Gallagher, Don Vicendese, Melissa Buultjens, Mehak Batra and Bircan Erbas
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Yibeltal Bekele: School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia
Claire Gallagher: School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
Don Vicendese: School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
Melissa Buultjens: School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia
Mehak Batra: School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia
Bircan Erbas: School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia

IJERPH, 2024, vol. 21, issue 7, 1-17

Abstract: Background: Iron and folate deficiency are prevalent in pregnant women in Africa. However, limited research exists on the differential effect of oral iron-only, folate-only, or Iron Folic Acid (IFA) supplementation on adverse pregnancy and infant outcomes. This systematic review addresses this gap, focusing on studies conducted in Africa with limited healthcare access. Understanding these differential effects could lead to more targeted and potentially cost-effective interventions to improve maternal and child health in these settings. Methods: A systematic review was conducted following PRISMA guidelines. The primary exposures were oral iron-only, folate-only, or IFA oral supplementation during pregnancy, while the outcomes were adverse pregnancy and infant outcomes. A qualitative synthesis guided by methods without meta-analysis was performed. Results: Our qualitative synthesis analysed 10 articles reporting adverse pregnancy (adverse birth outcomes, stillbirths, and perinatal mortality) and infant outcomes (neonatal mortality). Consistently, iron-only supplementation demonstrated a reduction in perinatal death. However, evidence is insufficient to assess the relationship between iron-only and IFA supplementation with adverse birth outcomes, stillbirths, and neonatal mortality. Conclusion: Findings suggested that iron-only supplementation during pregnancy may reduce perinatal mortality in African women. However, evidence remains limited regarding the effectiveness of both iron-only and IFA supplementation in reducing stillbirths, and neonatal mortality. Moreover, additional primary studies are necessary to comprehend the effects of iron-only, folate-only, and IFA supplementation on pregnancy outcomes and infant health in the African region, considering rurality and income level as effect modifiers.

Keywords: adverse birth outcomes; neonatal mortality; infant mortality; iron; folate; Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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