الفهرس 
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Abstract
I
ron deficiency anemia is the most common micronutrient deficiency in the world today. It impacts the lives of millions of women and children contributing to poor cognitive development, increased maternal mortality and decreased work capacity.
Yet with appropriate public health action, this form of micronutrient malnutrition can be brought under control, various interventions exist that are designed to prevent and correct iron deficiency anemia.
The major concern about the adverse effects of anemia on pregnant women is the belief that this population is at greater risk of perinatal mortality and morbidity, during pregnancy a series of continuous, physiological adjustments affect nutrient metabolism and energy requirements, malnourished women more likely bear growth-restricted babies. Nutrition and supplementation of minerals and vitamins are likely key factors in the prophylaxis and management (Bouzari 2011).
Iron is a micronutrient essential for hemoglobin synthesis and several organ functions. Fe deficiency is the most widespread nutrient deficiency in the world, affecting more than 50% of all pregnant women in developing countries. It may lead to anemia, intrauterine growth retardation (IUGR), and small for gestational age fetuses.
Folate is a water-soluble B vitamin that plays a major co-enzymatic role in carbon metabolism and in the synthesis of DNA, RNA and certain amino acids. Dietary folate deficiency is prevalent in developing countries. Deficiency may lead to congenital malformations (neural tube damage, orofacial clefts, cardiac anomalies), anemia and certain complications during pregnancy (spontaneous abortions, bleeding, pre-eclampsia, IUGR and abruptio- placentae).
Low folate status may also cause hyperhomocystemia, hypercoagulability and venous thrombosis.
To reduce risk of congenital malformations and pregnancy complications a daily supplemental dose of 400 mg/day of folate is recommended when planning pregnancy. Increased risk of fetal neural tube defects is seen in several conditions: obesity, personal or family history of neural tube defects, pregestational diabetes, and epilepsy. A higher dose (5 mg) is recommended in these previous situations (Hovdenak and Haram, 2012).
In this study a randomized controlled trail done on women selected from pregnant women attending the ante natal outpatient clinic of Ain Shams University maternity hospital according to the eligibility criteria measuring the efficacy of daily versus weekly iron and folate supplementation. The study was done on 160 pregnant non-anemic women, 14-22 weeks gestation, all patients were subjected to full present, past and obstetric history taking, full clinical examination, they were divided into two equal groups, hemoglobin and serum ferritin measured at the start of the study and repeated after four months of unsupervised treatment at home, first group had regimen contain 60 mg elemental iron and 1 mg folic acid for daily supplementation and second group receive 120 mg elemental iron and 3 mg folic acid weekly.
After four months of self-monitored treatment at home hemoglobin and serum ferritin levels re-measured with assessment of side effects and compliance as reported by candidates in both groups.
The results showed hemoglobin and serum ferritin levels elevation in both groups with non-significant difference between the two groups and better compliance in the weekly administration group showed by more commitment by women in this group to take their medications and lesser side effects in weekly group than daily one.
Side effects reported were, nausea, vomiting, constipation and gastric upset which were more applied to the daily group than weekly supplementation group.
About cost effectiveness as reported from study candidates the weekly regimen was more applicable to women and cheaper than daily one with fewer packages of iron and folate thus even for poor families they afforded to buy the treatment.
So we recommend that weekly regimen can be an effective alternative to daily supplementation in prophylaxis of iron deficiency anemia in non-anemic pregnant women.
Future studies could focus on effect of weekly regimen on treatment of anemia not just prophylaxis and linking the supplementation with pregnancy outcome measuring the effect of iron and folate supplementation on the fetuses.
Research in the near future, and international organizations, should perform the task to improve management of anemia worldwide, lowering costs of diagnostic tools in developing countries, finding new markers for iron states and revealing other relations between iron deficiency states and fetal–maternal complications.