Iron supplementation with or without folic acid to reduce the risk of postpartum anaemia
Anaemia is an important public health problem worldwide, particularly among women of reproductive age. A substantial portion of this anaemia burden is assumed to be due to iron deficiency. The consequences of anaemia resulting from iron deficiency during the postpartum period (six weeks after child birth) can be serious and have long-term health implications for the mother and her child.
There are limited data on the global prevalence of postpartum anaemia. Studies conducted in high-income countries have reported that 10–30% of postpartum women were anaemic. As anaemia is a common problem throughout the world, the prevalence of postpartum anaemia in low- and middle-income countries may be higher.
WHO recommends daily or intermittent iron and folic acid supplementation as a public health intervention for adult women and adolescent girls living in settings where anaemia is highly prevalent. In the postpartum period, iron and folic acid supplementation may also reduce the risk of anaemia by improving iron status of the mother.
Oral iron supplementation, either alone or in combination with folic acid, may be provided to postpartum women for 6–12 weeks following delivery for reducing the risk of anaemia in settings where gestational anaemia is of public health concern.*
* WHO considers a 20% or higher population prevalence of gestational anaemia to be a moderate public health problem
For ease of implementation and continuity of care, postpartum supplementation should begin as early as possible after delivery and the iron supplementation regimen (e.g. dose and whether consumed daily or weekly) should follow that used during pregnancy, or alternatively should start with that planned for non-pregnant adult women and adolescent girls.
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
Effects of preventive oral supplementation with iron or iron with folic acid for women following childbirth (protocol)