The 'test and treat' strategy in pregnancy-related anemia

In India, there is a significant prevalence of nutritional anemia caused by deficiencies in iron, folic acid, and vitamin B12. The National Anaemia Control Programme aimed to identify and treat anemic pregnant women, but its implementation was lacking, leading to persistently high anemia rates. 

A recent study aimed to address this issue by operationalizing hemoglobin estimation in an urban maternity center – evaluating the prevalence of iron, folic acid, and vitamin B12 deficiencies and conducting a randomized study on women with hemoglobin levels between 8.0 and 10.9 g/dL. 

The results showed that implementing a 'Test and Treat' strategy in the urban maternity center could successfully identify anemia. Initially, all enrolled women were anemic – with 60% having low ferritin levels. After eight weeks of iron folic acid (IFA) supplementation, there was a 50% reduction in the anemia prevalence. Continued supplementation until 38 weeks gestation resulted in a 70% reduction in the anemia prevalence. However, the addition of vitamin B12 to IFA did not significantly improve the mean hemoglobin or vitamin B12 levels. 

The findings suggested that IFA supplementation can effectively curb anemia during pregnancy with consistent supply and supervision.

Source: Sharma A, Ravinder P, Nair M, Kalaivani K, Ramachandran P. Indian J Obstet Gynecol Res. 2023;10(3):320-329