Combined iron and zinc supplementation improves haematologic status of pregnant women in Upper West Region of Ghana.

BACKGROUND Though pregnant women in Ghana routinely receive iron and folic acid supplements, the prevalence of anaemia continues to be as high as 70%. OBJECTIVE To determine the impact of zinc deficiency on iron status indicators in pregnant women. DESIGN A double-blind, randomized controlled trial (RCT) of joint iron and zinc supplementation. SETTING The study was conducted in the Upper West Region of Ghana, where the prevalence of anaemia is high. PARTICIPANTS The study population comprised pregnant women who presented themselves for antenatal care (ANC) in the Wa Regional Hospital of the Upper West Region in Ghana. INTERVENTIONS The intervention group received a combined supplement of 40 mg zinc as zinc gluconate and 40 mg iron as ferrous sulphate. The control group received 40 mg elemental iron as ferrous sulphate. MAIN OUTCOME MEASURES The primary outcome measures were mean and percentage changes in Hb. Serum ferritin and zinc concentrations serve as secondary outcomes. RESULTS Adjusted mean Hb increase was 0.6g/dl higher among women who were not iron replete (SF ferritin ≤ 20 µg/L) and received the iron-zinc supplement, compared to women who received iron-only supplement, F (1, 99) = 4.356, p = 0.039. Women who had low plasma zinc levels were 3-fold increased odds of developing iron deficiency at recruitment, (OR 3.41, 95% CI: 1.19-9.76). CONCLUSIONS Iron-zinc supplementation was effective in raising Hb and serum ferritin values among women who were iron deficient in early pregnancy but not among iron sufficient women.