Undesirable effects of a daily regimen of iron and folic acid ingested jointly are potential disincentives to optimal antenatal supplementation. We intended to profile antenatal iron-folate side effects and elucidate their influence on supplementation duration in low-resource rural Kenya.

Using a modified WHO Safe Motherhood Assessment standard questionnaire, they recalled the total number of days of antenatal iron-folate intake and the attendant supplement-attributed unpleasant experiences. The most commonly reported outcomes were chest pains, constipation, severe stomach pains, and diarrhoea. A more significant proportion of the former was the primigravida. They used a combined form of iron and folic acid. In a multivariate analysis, significant correlations with supplementation compliance were found only for nausea and severe stomach pain experiences.

The commonness of unpleasant experiences attributed to daily ingestion of 60 mg iron and 0.4 mg folic acid and their deterrence to longer supplementation durations suggest the need for considering a weekly intermittent regimen for some antenatal women in such set-ups. Our study demonstrated that potentially, more counselling on nausea as a side effect might be critical in advancing iron-folate supplementation compliance.

Reference: https://www.hindawi.com/journals/jp/2020/9621831/