Daily Iron Supplements For Maternal Anemia

A Cochrane Review is a trusted type of study that collects and analyzes evidence from high-quality clinical trials to give clear, unbiased answers to health questions.

A Cochrane Review evaluated how daily oral iron supplements—alone or with folic acid—affect women's health during pregnancy. The review included 57 studies with nearly 49,000 pregnant women worldwide.

For maternal health, iron supplements likely reduce the risk of anemia and iron deficiency by the end of pregnancy. Women who took iron were less likely to have iron-deficiency anemia (moderate-certainty evidence). There was little to no difference in maternal deaths, and evidence for serious side effects was unclear due to limited reporting.

For infant outcomes, babies born to mothers who took iron were slightly less likely to have low birthweight, and their birthweight may be modestly higher. However, there was little to no difference in rates of preterm birth, neonatal death, or birth defects. The evidence on long-term infant health, such as iron levels or development, remains limited.

When iron was combined with folic acid, results were similar: likely reduced anemia in mothers and slightly higher birthweight in babies. However, most infant outcomes did not differ meaningfully between supplement and control groups, and many findings were rated as low or very low certainty.

Overall, iron supplements appear to help prevent maternal anemia and may support slightly better birth outcomes. More research is needed to understand the long-term benefits and any potential risks.