e-Library of Evidence for Nutrition Actions (eLENA)

Intermittent iron and folic acid supplementation in non-anaemic pregnant women

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.

The use of daily iron and folic acid supplements throughout pregnancy has been the standard approach to prevent and treat iron deficiency anaemia. Despite its proven efficacy, the use of daily iron supplementation has been limited in programme settings, possibly due to a lack of compliance, concerns about the safety of the intervention among women with an adequate iron intake, and variable availability of the supplements at community level. Experience has shown that intermittent regimens may be more accepted by women, with increased adherence to supplementation programmes.

WHO recommendations

In populations where the prevalence of anaemia among pregnant women is lower than 20%, intermittent use of iron and folic acid supplements by non-anaemic pregnant women is recommended to prevent anaemia and improve gestational outcomes.


Additional information for this recommendation, including a suggested scheme for supplementation, 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'.

WHO documents

GRC-approved guidelines


Systematic reviews used to develop the guidelines
Related Cochrane reviews
Other related systematic reviews
Clinical trials

Last update:

27 April 2016 06:10 CEST

Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee

Essential Nutrition Actions

This intervention is an Essential Nutrition Action targeting the first 1000 days of life.