Treatment of anaemia in pregnancy with oral iron, folic acid or iron, folic acid and vitamin B12 supplementation: A hospital-based open randomized study

: National iron plus initiative recommended that anaemic pregnant women should be treated with 200 mg of elemental iron and 1 mg folic acid. An increase in vitamin B12 deficiency has been reported in last two decades. An open randomised study was taken up in urban antenatal clinics to assess the impact of addition of vitamin B12 to the iron and folic acid supplementation. : Anaemic pregnant women willing to participate in the study were randomised into Group 1 (240 iron mg and 5 mg folic acid) or Group 2 (240 mg iron, 1.5 mg of folic acid and 15 µg vitamin B12); the impact of supplementation on Hb, ferritin, folic acid and vitamin B12 was assessed. : In both groups mean Hb improved by 1g/dL at 8 weeks and by 1.5g/dL by 38 weeks of pregnancy; at 38 weeks only 30% were anaemic. Mean ferritin and folic acid levels improved in both groups. There was a fall in the mean vitamin B12 levels in the group which received 5 mg of folic acid. : With assured supply and supportive supervision, the supplementation achieved substantial reduction in anaemia in both groups. Supplementation with folic acid 5 mg should not be done because it causes a fall in vitamin B12 levels. The reason why addition of vitamin B12 to iron folic acid supplementation did not result in improvement in mean Hb, or vitamin B12 levels has to be investigated.