Cochrane · systematic review · CD009218
Intermittent iron supplementation for reducing anaemia and its associated impairments in adolescent and adult menstruating women
Fernández-Gaxiola, AC, De-Regil, LM · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 2 · 14.3%Very low 1 · 7.1%Low 8 · 57.1%Moderate 3 · 21.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyIntermittent iron supplementation (alone or with any other micronutrients) versus no supplementation or placebo in menstruating women
Population: adolescent and adult menstruating women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anaemia (haemoglobin concentration below a cut‐off defined by the trialists, adjusted by altitude and smoking as appropriate) Intermittent iron supplementation (alone or with any other micronutrients) vs no supplementation or placebo | RR 0.65 [0.49, 0.87] | 11 studies · 3135 participants | Low Downgraded: risk of bias, inconsistency |
Haemoglobin (g/L) Intermittent iron supplementation (alone or with any other micronutrients) vs no supplementation or placebo | no estimate extracted | 15 studies · 2886 participants | Moderate Downgraded: inconsistency |
Iron deficiency (as defined by trialists by using indicators of iron status such as ferritin or transferrin) Intermittent iron supplementation (alone or with any other micronutrients) vs no supplementation or placebo | RR 0.5 [0.24, 1.04] | 3 studies · 624 participants | Low Downgraded: imprecision, inconsistency |
Ferritin (µg/L) Intermittent iron supplementation (alone or with any other micronutrients) vs no supplementation or placebo | no estimate extracted | 7 studies · 1067 participants | Low Downgraded: risk of bias, imprecision |
Iron deficiency anaemia (as defined by the presence of anaemia plus iron deficiency diagnosed with an indicator of iron status selected by the trialists) Intermittent iron supplementation (alone or with any other micronutrients) vs no supplementation or placebo | RR 0.07 [0, 1.16] | 1 study · 97 participants | Low Downgraded: risk of bias, imprecision |
All‐cause morbidity (the most frequent event associated with the intervention, independent of the cause, as defined by the trialists) Intermittent iron supplementation (alone or with any other micronutrients) vs no supplementation or placebo | RR 1.12 [0.82, 1.52] | 1 study · 119 participants | Low Downgraded: risk of bias, imprecision |
Any adverse side effects Intermittent iron supplementation (alone or with any other micronutrients) vs no supplementation or placebo | RR 1.98 [0.31, 12.72] | 3 studies · 630 participants | Moderate Downgraded: inconsistency |
Intermittent iron supplementation versus daily iron supplementation in menstruating women
Population: adolescent and adult menstruating women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anaemia (haemoglobin concentration below a cut‐off defined by the trialists, adjusted by altitude and smoking as appropriate) Intermittent iron supplementation vs daily iron supplementation | RR 1.09 [0.93, 1.29] | 8 studies · 1749 participants | Moderate Downgraded: risk of bias |
Haemoglobin (g/L) Intermittent iron supplementation vs daily iron supplementation | no estimate extracted | 10 studies · 2127 participants | Low Downgraded: inconsistency |
Iron deficiency (as defined by the trialists using indicators of iron status such as ferritin or transferrin) Intermittent iron supplementation vs daily iron supplementation | RR 4.3 [0.56, 33.2] | 1 study · 198 participants | Very low Downgraded: risk of bias, imprecision |
Ferritin (µg/L) Intermittent iron supplementation vs daily iron supplementation | no estimate extracted | 4 studies · 988 participants | Low Downgraded: inconsistency |
Iron deficiency anaemia (as defined by the presence of anaemia plus iron deficiency, diagnosed with an indicator of iron status selected by the trialists) Intermittent iron supplementation vs daily iron supplementation | no estimate extracted | 0 studies · 0 participants | Ungraded |
All‐cause morbidity (the most frequent event associated with the intervention, independent of the cause, as defined by the trialists) Intermittent iron supplementation vs daily iron supplementation | no estimate extracted | 0 studies · 0 participants | Ungraded |
Any adverse side effects Intermittent iron supplementation vs daily iron supplementation | RR 0.41 [0.21, 0.82] | 6 studies · 1166 participants | Low Downgraded: inconsistency |
Intermittent use of iron supplements versus placebo/no intervention in menstruating women
Population: menstruating women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anaemia (as defined by trialists) Intermittent use of iron supplements vs placebo/no intervention | RR 0.73 [0.56, 0.95] | 10 studies · 2996 participants | Low |
Haemoglobin (g/L) Intermittent use of iron supplements vs placebo/no intervention | MD 4.58 [2.56, 6.59] | 13 studies · 2599 participants | Low |
Iron deficiency (as defined by trialists) Intermittent use of iron supplements vs placebo/no intervention | RR 0.5 [0.24, 1.04] | 3 studies · 624 participants | Low |
Iron status (ferritin in μg/L) Intermittent use of iron supplements vs placebo/no intervention | MD 8.32 [4.97, 11.66] | 6 studies · 980 participants | Low |
Iron deficiency anaemia (anaemia and one indicator of iron deficiency) Intermittent use of iron supplements vs placebo/no intervention | RR 0.07 [0, 1.16] | 1 study · 193 participants | Very low |
All‐cause morbidity Intermittent use of iron supplements vs placebo/no intervention | RR 1.12 [0.82, 1.52] | 1 study · 119 participants | Very low |
Intermittent versus daily use of iron supplements in menstruating women
Population: menstruating women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anaemia (as defined by trialists) Intermittent vs daily use of iron supplements | RR 1.26 [1.04, 1.51] | 6 studies · 1492 participants | Moderate |
Haemoglobin (g/L) Intermittent vs daily use of iron supplements | no estimate extracted | 8 studies · 1676 participants | Low |
Iron deficiency (as defined by trialists) Intermittent vs daily use of iron supplements | RR 4.3 [0.56, 33.2] | 1 study · 198 participants | Very low |
Iron status (ferritin in μg/L) Intermittent vs daily use of iron supplements | no estimate extracted | 3 studies · 657 participants | Low |
Iron deficiency anaemia (anaemia and one indicator of iron deficiency) Intermittent vs daily use of iron supplements | no estimate extracted | 0 studies · 0 participants | Ungraded |
All‐cause morbidity Intermittent vs daily use of iron supplements | no estimate extracted | 0 studies · 0 participants | Ungraded |