Effect of Iron-Folate Supplementation on Maternal Hematological Parameters among Pregnant Women in Addis Ababa, Ethiopia: An Institutional Multi-center Prospective Follow-up Study

Abstract

<title>Abstract</title> Background Iron-folate (IFA) supplementation is a well-established strategy for reducing anemia in pregnant women. Studies on the extent to which it reduces maternal anemia, its effect on leukocytes and platelet count are limited and require further investigation. Objective This study aimed to assess effect of iron folate supplementation on maternal hematological parameters among pregnant women in public hospitals in Addis Ababa, Ethiopia. Methods An institution-based prospective follow-up study was conducted in public hospitals in Addis Ababa from May 1, 2023, to March 30, 2024, with 410 participants selected through systematic random sampling. Data collection involved interviews, medical record reviews, and laboratory tests. Statistical analysis was performed using SPSS Version 27, including Shapiro-Wilk test, descriptive statistics, paired sample t-tests, and Wilcoxon signed-rank tests. A p-value of less than 0.05 was considered significant. Results The RBC count significantly increased in both sets of respondents. In non-anemic individuals, it rose from a baseline of 4.51 ± 0.43 to 4.70 ± 0.54 million cells per microliter (P &lt; 0.001), while in anemic respondents, it increased from 4.05 ± 0.37 to 4.23 ± 0.39 million cells per microliter (P &lt; 0.001). Similarly, the platelet count decreased across both groups. In anemic participants, it dropped from 293.3 ± 37.01 to 285.4 ± 37.83 thousand per microliter (P &lt; 0.01), and in non-anemic pregnant women, it declined from 274.9 ± 56.3 to 254.29 ± 59.07 thousand per microliter (P &lt; 0.001). After supplementation, no significant change in leukocyte count was observed in both anemic and non-anemic pregnant women (p = 0.065 and p &lt; 0.059) respectively. Conclusion Iron-folate supplementation significantly increased RBC counts in both anemic and non-anemic pregnant women, with a slight decrease in platelet counts and no change in leukocyte levels. Further research on the effect of iron folate intake on hematological indices is recommended.