Daily iron and folic acid supplementation during pregnancy
It is estimated that more than 40% of pregnant women worldwide are anaemic. At least half of this anaemia burden is assumed to be due to iron deficiency.
Pregnant women require additional iron and folic acid to meet their own nutritional needs as well as those of the developing fetus. Deficiencies in iron and folic acid during pregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development.
Evidence has shown that the use of iron and folic acid supplements is associated with a reduced risk of iron deficiency and anaemia in pregnant women.
Daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron* and 400 µg (0.4 mg) folic acid** is recommended for pregnant women to prevent maternal anaemia, puerperal sepsis, low birth weight, and preterm birth.***
*The equivalent of 60 mg of elemental iron is 300 mg ferrous sulfate heptahydrate, 180 mg ferrous fumarate or 500 mg of ferrous gluconate.
** Folic acid should be commenced as early as possible (ideally before conception) to prevent neural tube defects.
*** This recommendation supercedes the previous recommendation found within the WHO guideline ‘Daily iron and folic acid supplementation in pregnant women’ (2012).
Additional information for this recommendation can be found in the guidance summary and in the guideline, under 'WHO documents' below.
This is one of several WHO recommendations on iron and folic acid supplementation. The full set of recommendations can be found in 'Full set of recommendations'.
Systematic reviews used to develop the guidelines
Related systematic reviews
Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis
Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis
Routine iron/folate supplementation during pregnancy: effect on maternal anaemia and birth outcomes