This is not the most recent version of the article. View current version (7 DEC 2011)

Intervention Protocol

You have free access to this content

Intermittent iron supplementation for reducing anaemia and its associated impairments in menstruating women

  1. Ana C Fernández-Gaxiola2,
  2. Luz Maria De-Regil1,*,
  3. Mona Nasser3

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 6 JUL 2011

DOI: 10.1002/14651858.CD009218

How to Cite

Fernández-Gaxiola AC, De-Regil LM, Nasser M. Intermittent iron supplementation for reducing anaemia and its associated impairments in menstruating women (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD009218. DOI: 10.1002/14651858.CD009218.

Author Information

  1. 1

    World Health Organization, Micronutrients Unit, Department of Nutrition for Health and Development, Geneva, Switzerland

  2. 2

    Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico

  3. 3

    University of Plymouth, Peninsula Dental School, Plymouth, UK

*Luz Maria De-Regil, Micronutrients Unit, Department of Nutrition for Health and Development, World Health Organization, 20 Avenue Appia, Geneva, 1211, Switzerland.

Publication History

  1. Publication Status: New
  2. Published Online: 6 JUL 2011


This is not the most recent version of the article. View current version (07 DEC 2011)


Additional references

Ahmed 2008
  • Ahmed F, Khan MR, Banu CP, Qazi MR, Akhtaruzzaman M. The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangaldesh. European Journal of Clinical Nutrition 2008;62(3):365-72.
Allen 2009
  • Allen LH, Peerson JM, Maternal Micronutrient Supplementation Study Group (MMSSG). Impact of multiple micronutrient versus iron-folic acid supplements on maternal anemia and micronutrient status in pregnancy. Food and Nutrition Bulletin 2009;30(4):S527-32.
Allen 2009a
  • Allen LH, Peerson JM, Olney DK. Provision of multiple rather than two or fewer micronutrients more effectively improves growth and other outcomes in micronutrient deficient children and adults. Journal of Nutrition 2009;139(5):1022-30.
Alleyne 2008
Anah 2008
  • Anah MU, Ikpeme OE, Etuk IS, Yong KE, Ibanga I, Asuquo BE. Worm infestation and anemia among pre-school children of peasant farmers in Calabar, Nigeria. Nigerian Journal of Clinical Practice 2008;11(3):220-4.
Anderson 2005
Balshem 2010
  • Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: rating the quality of evidence. Journal of  Clinical Epidemiology 2011;64(4):401-6.
Beard 2001
  • Beard JL. Iron biology in immune function, muscle metabolism and neuronal functioning. Journal of Nutrition 2001;131(2):S568-79.
Beard 2005
  • Beard JL, Hendricks MK, Perez EM, Murray-Kolb LE, Berg A, Vernon-Feagans L, et al. Maternal iron deficiency anemia affects postpartum emotions and cognition. Journal of Nutrition 2005;135(2):267-72.
Beaton 1999
  • Beaton GH, McCabe GP. Efficacy of Intermittent Iron Supplementation in the Control of Iron Deficiency Anemia in Developing Countries: An Analysis of Experience. Toronto, Canada: GHB Consulting, 1999.
Bentley 2003
Bodnar 2002
Casanueva 2006
  • Casanueva E, Viteri FE, Mares-Galindo M, Meza-Camacho C, Loría A, Schnaas L, et al. Weekly iron as a safe alternative to daily supplementation for nonanemic pregnant women. Archives of Medical Research 2006;37(5):674-82.
Clark 2008
Crape 2005
  • Crape BL, Kenefick E, Cavalli-Sfroza T, Bush-Hallen J, Milano S, Kanal K. Positive impact of a weekly iron-folic acid supplement delivered with social marketing to Cambodian women: compliance, participation, and hemoglobin levels increase with higher socioeconomic status. Nutrition Reviews 2005;63(1 suppl):134-8.
Dalmiya 2009
  • Dalmiya N, Darnton-Hill I, Schultink W, Shrimpton R. Multiple micronutrient supplementation during pregnancy: a decade of collaboration in action. Food and Nutrition Bulletin 2009;30(4):S477-9.
De-Regil 2010
DeMaeyer 1989
  • DeMaeyer EM. Preventing and Controlling Iron Deficiency Anaemia Through Primary Health Care. Geneva: World Health Organization, 1989.
Egger 1997
Gajida 2010
  • Gajida AU, IIiyasu Z, Zoakah Al. Malaria among antenatal clients attending primary health care facilities in Kano state, Nigeria. Annals of Africian Medicine 2010;9(3):188-93.
GRADEpro 2008
  • Brozek J, Oxman A, Schünemann H. GRADEpro. 3.2 for Windows. Grade Working Group, 2008.
Herbert 1987
  • Herbert V. The 1986 Herman award lecture. Nutrition science as a continually unfolding story: the folate and vitamin B-12 paradigm. American Journal of Clinical Nutrition 1987;46(3):387-402.
Hercberg 1992
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated March 2011]. The Cochrane Collaboration, 2011. Available from The Cochrane Collaboration.
Jimenez 2010
  • Jimenez C, Leets I, Puche R, Anzola E, Montilla R, Parra C, et al. A single dose of vitamin A improves haemoglobin concentration, retinol status and phagocytic function of neutrophils in preschool children. British Journal of Nutrition 2010;103(6):798-802.
Khan 2005
  • Khan NC, Thanh HTK, Berger J, Hoa PT, Quang ND, Smitasiri S, et al. Community mobilization and social marketing to promote weekly iron-folic acid supplementation: a new approach toward controlling anemia among women of reproductive age in Vietnam. Nutrition Reviews 2005;63(12 Pt 2):87-94.
Kianfar 2000
  • Kianfar H, Kimiagar M, Ghaffarpour M. Effect of daily and intermittent iron supplementation on iron status of high school girls. International Journal for Vitamin and Mineral Nutrition Research 2000;70(4):172-7.
Kontic-Vucinic 2006
  • Kontic-Vucinic O, Sulovic N, Radunovic N. Micronutrients in women's reproductive health: II. Minerals and trace elements. International Journal of Fertility and Women's Medicine 2006;51(3):116-24.
Kumar 2007
  • Kumar A, Valecha N, Jain T, Dash AP. Burden of malaria in India: retrospective and prospective view. American Journal of Tropical Medicine and Hygiene 2007;77(6 suppl):69-78.
Lynch 2007
  • Lynch S. Iron metabolism. In: Kraemer K, Zimmermann MB editor(s). Nutritional Anemia. Basel: Sight and Life Press, 2007:59-76.
Martinez-de Villareal 2001
  • Martinez-de Villareal LE, Limón-Benavides C, Valdez-Leal R, Sánchez-Peña MA, Villareal-Pérez JZ. Impact of weekly administration of folic acid on folic acid blood levels. Salud Publica de Mexico 2001;43(2):103-7.
Martinez-de Villareal 2002
McLean 2008
  • McLean E, de Benoist B, Allen LH. Review of the magnitude of folate and vitamin B12 deficiencies worldwide. Food and Nutrition Bulletin 2008;29(2 suppl):S38-51.
Nguyen 2008
  • Nguyen P, Grajeda R, Melgar P, Marcinkevage J, Flores R, Martorell R. Weekly may be as efficacious as daily folic acid supplementation in improving folate status and lowering serum homocysteine concentrations in Guatemalan women. Journal of Nutrition 2008;138(8):1491-8.
Norsworthy 2004
  • Norsworthy B, Skeaff CM, Adank C, Green TJ. Effects of once-a-week or daily folic acid supplementation on red blood cell folate concentrations in women. European Journal of Clinical Nutrition 2004;58(3):548-54.
Oates 2007
Ojukwu 2009
Olsen 2000
  • Olsen A, Nawiri J, Friis H. The impact of iron supplementation on reinfection with intestinal helminths andSchistosoma mansoni in western Kenya. Transactions of the Royal Society of Tropical Medicine and Hygiene 2000;94(5):493-9.
Oppenheimer 2001
  • Oppenheimer SJ. Iron and its relation to immunity and infectious disease. Journal of Nutrition 2001;131(2):S616-35.
Paulino 2005
  • Paulino LS, Angeles-Agdeppa I, Etorma UM, Ramos AC, Cavalli-Sforza T. Weekly iron-folic acid supplementation to improve iron status and prevent pregnancy anemia in Filipino women of reproductive age. Nutrition Reviews 2005;63(1 suppl):109-15.
Peña-Rosas 2011
  • Peña-Rosas JP, De-Regil LM, Dowswell T, Viteri FE. Effectiveness of intermittent iron and folic acid supplementation regimens for women during pregnancy. Cochrane Database of Systematic Reviews 2011, Issue 4. [DOI: 10.1002/14651858.CD004736.pub3]
Prentice 2007
Ramakrishnan 2002
RevMan 2011
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager [RevMan]. 5.1.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Soekarjo 2001
  • Soekarjo DD, de Pee S, Bloem MW, Tjiong R, Yip R, Schreurs WH, et al. Socio-economic status and puberty are the main factors determining anaemia in adolescent girls and boys in East Java, Indonesia. European Journal of Clinical Nutrition 2001;55(11):932-39.
Sylvetsky 2011
  • Sylvetsky AC, Jefferds MED, De-Regil LM, Dowswell T. Intermittent iron supplementation for improving nutrition and developmental outcomes in children. Cochrane Database of Systematic Reviews 2011, Issue 4. [DOI: 10.1002/14651858.CD009085]
Viteri 1995
  • Viteri FE, Xunian L, Tolomei K, Martin A. True absorption and retention of supplemental iron in women deficient when iron is administered every three days rather than daily to iron-normal and iron-deficient rats. Journal of Nutrition 1995;125:82-91.
Viteri 2005
  • Viteri FE, Berger J. Importance of pre-pregnancy and pregnancy iron status: can long-term weekly preventive iron and folic acid supplementation achieve desirable and safe status?. Nutrition Reviews 2005;63(12):S65-76.
WHO 2001
  • World Health Organization. Iron Deficiency Anaemia: Assessment, Prevention and Control. A Guide for Programme Managers. Geneva: World Health Organization, 2001.
WHO 2008
  • World Health Organization. The Global Burden of Disease: 2004 update. Geneva: World Health Organization, 2008.
WHO 2009
  • World Health Organization. Weekly Iron-folic Acid Supplementation (WIFS) in Women of Reproductive Age: Its Role in Promoting Optimal Maternal and Child Health. Position Statement. Geneva: World Health Organization, 2009.
WHO 2011
  • World Health Organisation. Serum Retinol Concentrations for Determining the Prevalence of Vitamin A Deficiency in Populations. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization, 2011.
WHO 2011a
  • World Health Organisation. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization, 2011.
WHO 2011b
  • WHO. Serum Ferritin Concentrations for the Assessment of Iron Status and Iron Deficiency in Populations. Vitamin and Mineral Nutrition Information System. Geneva, Switzerland: World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.2).
WHO/CDC 2008
  • World Health Organization/Centers for Disease Control and Prevention. In: Bruno de Benoist, Erin McLean, Ines Egli, Mary Cogswell editor(s). Worldwide Prevalence of Anaemia 1993-2005: WHO Global Database on Anaemia. Geneva: World Health Organization, 2008.
Yip 1988
Yip 1994
  • Yip R. Iron deficiency: contemporary scientific issues and international programmatic approaches. Journal of Nutrition 1994;124(8 suppl):S1479-90.