Hi Pierre, Nice to hear from you. I can't give you factual research based statistics on what your looking at but I can give a opinion based on lots of practical prenatal work: getting women to take iron supplementation in Canada is very hard, it often constipates them and makes them nauseous. I often find getting women with iron deficiency to take supplements is a constant frustrating battle. For me to consider this as routine for women with a normal Hb I would need 100% proof of significant outcome difference, and I am not aware of any that exists. Of course Africa is different because the average woman is walking around with Hb of 9 and a bout of malaria can send them plummeting. And unlike here blood transfusion in general is not a safe option as a bail out in an emergency. Hope you are well. Ann Duggan --- Pierre and Lee Ann Dil <[log in to unmask]> wrote: > Dear colleagues, > > I want to do a small literature review > as part of my family practice residency, which > should answer a "clinical > question". > I have been involved in iron supplementaion > programmes in Malawi in > Africa and Zambia, and I know that in Africa we > generally say that > iron supplementation is imperative in the antenatal > period, for all > women. Here in Canada I find that only select groups > receive iron in > pregnancy, such as those with a short birth > interval, those with > established low haemoglobin, and a few other > instances. > > I am interested in hearing back as to whether you > think it is valid to > NOT give iron supplementation to all pregnant women? > Is this at all a > contentious area, or have there been very clear > clinical guidelines > established (and are these based on good reserach)? > > Another question, which might be outside of the > expertise in this > group, is whether there is proven maternal morbidity > and perinatal > mortality, in women with low iron stores (as > measured for instance > through ferritin or transeferrin receptor levels) > and NORMAL > haemoglobin? > > Many thanks and I hope to hear from you. > > Pierre Dil > home page > http://members.truepath.com/dil/dil.html > > international health page > http://www.geocities.com/HotSprings/Falls/2949/ihealth.htm > __________________________________________________ Do You Yahoo!? Bid and sell for free at http://auctions.yahoo.com