Bibliographic Info
GuidelineWHO recommendations on antenatal care for a positive pregnancy experience
Year of Publication2016
Issuing InstitutionWHO
Recommendation
Status
Maintained
Context specific recommendation
Only in specific contexts
Intermittent oral iron and folic acid supplementation with 120 mg of elemental ironc and 2800 µg (2.8 mg) folic acid once weekly is recommended for pregnant women to improve maternal and neonatal outcomes if daily iron is not acceptable due to side-effects, and in populations with an anaemia prevalence among pregnant women of less than 20%.
Notes and Remarks
- 1.The equivalent of 120 mg of elemental iron is 600 mg ferrous sulfate heptahydrate, 360 mg ferrous fumarate or 1000 mg ferrous gluconate. This recommendation supersedes the previous WHO recommendation in the 2012 Guideline: intermittent iron and folic acid supplementation in non-anaemic pregnant women and should be considered alongside Recommendation A.1.1.
- 2.In general, anaemia prevalence of less than 20% is classified as a mild public health problem (33).
- 3.Before commencing intermittent iron supplementation, accurate measurement of maternal blood Hb concentrations is needed to confirm the absence of anaemia. Therefore, this recommendation may require a strong health system to facilitate accurate Hb measurement and to monitor anaemia status throughout pregnancy.
- 4.If a woman is diagnosed with anaemia (Hb < 110 g/L) during ANC, she should be given 120 mg of elemental iron and 400 μg (0.4 mg) of folic acid daily until her Hb concentration rises to normal (Hb 110 g/L or higher) (34, 51). Thereafter, she can continue with the standard daily antenatal iron and folic acid dose (or the intermittent regimen if daily iron is not acceptable due to side-effects) to prevent recurrence of anaemia.
- 5.Stakeholders may need to consider ways of reminding pregnant women to take their supplements on an intermittent basis and of assisting them to manage associated side-effects.
Also Featured In
This recommendation also appears in the following guidelines:
Guideline
WHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025
Year2023
InstitutionWorld Health Organization