Effects and safety of preventive oral iron or iron+folic acid supplementation for women during pregnancy

Juan Pablo Peña‐Rosas; Fernando E Viteri

doi:10.1002/14651858.CD004736.pub3

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Figure 1

Funnel plot of comparison: 1 Daily iron alone versus no intervention/placebo, outcome: 1.7 Maternal Hb concentration at term (g/L) (ALL).

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Figure 2

Funnel plot of comparison: 1 Daily iron alone versus no intervention/placebo, outcome: 1.9 Anaemia at term (Hb less than 110 g/L).

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Analysis 1.1

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 1 Low birthweight (less than 2500 g) (ALL).

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Analysis 1.2

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 2 Low birthweight (less than 2500 g) (BY SUBGROUPS).

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Analysis 1.3

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 3 Birthweight (g) (ALL).

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Analysis 1.4

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 4 Birthweight (g) (BY SUBGROUPS).

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Analysis 1.5

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 5 Premature delivery (less than 37 weeks of gestation) (ALL).

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Analysis 1.6

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 6 Premature delivery (less 37 weeks of gestation) (BY SUBGROUPS).

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Analysis 1.7

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 7 Maternal Hb concentration at term (g/L) (ALL).

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Analysis 1.8

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 8 Maternal Hb concentration at term (g/L) (BY SUBGROUPS).

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Analysis 1.9

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 9 Anaemia at term (Hb less than 110 g/L) (ALL).

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Analysis 1.10

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 10 Haemoconcentration at term (Hb more than 130 g/L) (ALL).

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Analysis 1.11

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 11 Haemoconcentration at term (Hb more than 130 g/L) (BY SUBGROUPS).

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Analysis 1.12

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 12 Haemoconcentration during second or third trimester (ALL).

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Analysis 1.13

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 13 Haemoconcentration during second or third trimester (BY SUBGROUPS).

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Analysis 1.14

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 14 Iron deficiency at term (as defined by two or more indicators) (ALL).

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Analysis 1.15

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 15 Iron deficiency at term (as defined by two or more indicators) (BY SUBGROUPS).

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Analysis 1.16

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 16 Iron deficiency anaemia at term (ALL).

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Analysis 1.17

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 17 Iron deficiency anaemia at term (BY SUBGROUPS).

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Analysis 1.18

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 18 Side‐effects (Any) (ALL).

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Analysis 1.19

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 19 Side‐effects (Any) (BY SUBGROUPS).

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Analysis 1.20

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 20 Very low birthweight (less than 1500 g) (ALL).

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Analysis 1.21

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 21 Perinatal death (ALL).

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Analysis 1.24

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 24 Infant Hb concentration at 3 months (g/L) (ALL).

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Analysis 1.25

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 25 Infant serum ferritin concentration at 3 months (ug/L) (ALL).

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Analysis 1.26

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 26 Infant Hb concentration at 6 months (g/L) (ALL).

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Analysis 1.27

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 27 Infant serum ferritin concentration at 6 months (ug/L) (ALL).

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Analysis 1.29

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 29 Admission to special care unit (ALL).

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Analysis 1.30

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 30 Very premature delivery (less than 34 weeks' gestation) (ALL).

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Analysis 1.31

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 31 Severe anaemia at term (Hb less than 70 g/L) (ALL).

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Analysis 1.32

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 32 Moderate anaemia at term (Hb more than 70 g/L and less than 90 g/L) (ALL).

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Analysis 1.33

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 33 Severe anaemia at any time during second and third trimester (ALL).

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Analysis 1.34

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 34 Moderate anaemia at any time during second or third trimester (ALL).

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Analysis 1.35

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 35 Infection during pregnancy (including urinary tract infections) (ALL).

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Analysis 1.36

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 36 Puerperal infection (ALL).

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Analysis 1.37

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 37 Antepartum haemorraghe (ALL).

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Analysis 1.38

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 38 Postpartum haemorraghe (ALL).

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Analysis 1.39

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 39 Transfusion provided (ALL).

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Analysis 1.40

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 40 Haemoglobin concentration within one month postpartum (ALL).

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Analysis 1.41

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 41 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL).

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Analysis 1.42

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 42 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 100 g/L) (ALL).

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Analysis 1.43

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 43 Diarrhoea (ALL).

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Analysis 1.44

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 44 Constipation (ALL).

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Analysis 1.45

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 45 Nausea (ALL).

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Analysis 1.46

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 46 Heartburn (ALL).

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Analysis 1.47

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 47 Vomiting (ALL).

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Analysis 1.48

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 48 Maternal death (death while pregnant or within 42 days of termination of pregnancy) (ALL).

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Analysis 1.49

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 49 Maternal wellbeing/satisfaction (ALL).

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Analysis 1.50

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 50 Placental abruption (ALL).

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Analysis 1.51

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 51 Premature rupture of membranes (ALL).

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Analysis 1.52

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 52 Pre‐eclampsia (ALL).

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Analysis 1.91

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 91 Small for gestational age (less than 10th percentile weight at birth for gestational age) (not pre‐specified).

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Analysis 1.93

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 93 Cesarean delivery (not pre‐specified).

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Analysis 1.94

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 94 Birth length in cm (not pre‐specified).

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Analysis 1.95

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 95 Forceps or vacuum delivery (not pre‐specified).

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Analysis 1.96

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 96 Breastfeeding at least 4 months (not pre‐specified).

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Analysis 1.97

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 97 Haemoglobin concentration at 4‐8 weeks' postpartum (g/L) (not pre‐specified).

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Analysis 1.98

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 98 Apgar score < 7 at 5 minutes (not pre‐specified).

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Analysis 1.99

Comparison 1 Daily iron alone versus no intervention/placebo, Outcome 99 Apgar Score at 5 min (not pre‐specified).

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Analysis 2.3

Comparison 2 Intermittent iron alone versus daily iron alone, Outcome 3 Birthweight (ALL).

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Analysis 2.5

Comparison 2 Intermittent iron alone versus daily iron alone, Outcome 5 Premature delivery (less than 37 weeks of gestation) (ALL).

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Analysis 2.12

Comparison 2 Intermittent iron alone versus daily iron alone, Outcome 12 Haemoconcentration during second or third trimester (Hb more than 130 g/L) (ALL).

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Analysis 2.33

Comparison 2 Intermittent iron alone versus daily iron alone, Outcome 33 Severe anaemia at any time during second and third trimester (Hb less than 70 g/L) (ALL).

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Analysis 2.34

Comparison 2 Intermittent iron alone versus daily iron alone, Outcome 34 Moderate anaemia at any time during second or third trimester (ALL).

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Analysis 3.1

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 1 Low birthweight (less than 2500 g) (ALL).

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Analysis 3.2

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 2 Low birthweight (less than 2500 g) (BY SUBGROUPS).

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Analysis 3.3

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 3 Birthweight (ALL).

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Analysis 3.4

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 4 Birthweight (BY SUBGROUPS).

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Analysis 3.5

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 5 Premature delivery (less than 37 weeks of gestation) (ALL).

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Analysis 3.6

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 6 Premature delivery (less than 37 weeks of gestation) (BY SUB GROUPS).

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Analysis 3.7

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 7 Haemoglobin concentration at term (ALL).

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Analysis 3.8

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 8 Haemoglobin concentration at term (BY SUBGROUPS).

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Analysis 3.9

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 9 Anaemia at term (Hb less than 110 g/L) (ALL).

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Analysis 3.10

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 10 Haemoconcentration at term (Hb more than 130 g/L) (ALL).

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Analysis 3.11

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 11 Haemoconcentration at term (Hb more than 130 g/L) (BY SUBGROUPS).

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Analysis 3.12

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 12 Haemoconcentration during second or third trimester (ALL).

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Analysis 3.13

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 13 Haemoconcentration during second or third trimester (BY SUBGROUPS).

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Analysis 3.14

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 14 Iron deficiency at term (as defined by two or more indicators) (ALL).

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Analysis 3.15

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 15 Iron deficiency at term (as defined by two or more indicators) (BY SUBGROUPS).

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Analysis 3.16

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 16 Iron deficiency anaemia at term (ALL).

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Analysis 3.17

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 17 Iron deficiency anaemia at term (BY SUBGROUPS).

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Analysis 3.18

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 18 Side effects (Any) (ALL).

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Analysis 3.20

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 20 Very low birthweight (less than 1500 g) (ALL).

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Analysis 3.21

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 21 Perinatal death (ALL).

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Analysis 3.29

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 29 Admission to special care unit (ALL).

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Analysis 3.30

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 30 Very premature delivery (less than 34 weeks' gestation) (ALL).

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Analysis 3.31

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 31 Severe anaemia at term (Hb less than 70 g/L) (ALL).

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Analysis 3.32

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 32 Moderate anaemia at term (Hb more than 70g/L and less than 90 g/L) (ALL).

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Analysis 3.33

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 33 Severe anaemia at any time during second and third trimester (Hb less than 70 g/L) (ALL).

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Analysis 3.34

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 34 Moderate anaemia at any time during second or third trimester (ALL).

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Analysis 3.35

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 35 Infection during pregnancy (including urinary tract infections) (ALL).

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Analysis 3.36

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 36 Puerperal infection (ALL).

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Analysis 3.37

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 37 Antepartum haemorrhage (ALL).

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Analysis 3.38

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 38 Postpartum haemorrhage (ALL).

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Analysis 3.40

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 40 Haemoglobin concentration within one month postpartum (ALL).

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Analysis 3.41

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 41 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL).

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Analysis 3.42

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 42 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 100 g/L) (ALL).

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Analysis 3.48

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 48 Maternal death (death while pregnant or within 42 days of termination of pregnancy) (ALL).

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Analysis 3.50

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 50 Placental abruption (ALL).

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Analysis 3.52

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 52 Pre‐eclampsia (ALL).

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Analysis 3.91

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 91 Small for gestational age (less than 10th percentile weight at birth for gestational age) (not pre‐specified).

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Analysis 3.92

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 92 Oedema during pregnancy (not pre‐specified).

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Analysis 3.93

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 93 Caesarean delivery (not pre‐specified).

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Analysis 3.94

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 94 Birth length in cm (not pre‐specified).

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Analysis 3.97

Comparison 3 Daily iron‐folic acid versus no intervention/placebo, Outcome 97 Haemoglobin concentration at 4‐8 weeks postpartum (not prespecified).

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Analysis 4.1

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 1 Low birthweight (less than 2500 g) (ALL).

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Analysis 4.2

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 2 Low birthweight (less than 2500 g) (BY SUBGROUPS).

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Analysis 4.3

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 3 Birthweight (ALL).

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Analysis 4.4

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 4 Birthweight (BY SUBGROUPS).

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Analysis 4.5

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 5 Premature delivery (less than 37 weeks of gestation) (ALL).

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Analysis 4.7

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 7 Haemoglobin concentration at term (ALL).

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Analysis 4.8

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 8 Haemoglobin concentration at term (BY SUBGROUPS).

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Analysis 4.9

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 9 Anaemia at term (Hb < 110 g/L) (ALL).

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Analysis 4.10

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 10 Haemoconcentration at term (Hb more than 130 g/L) (ALL).

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Analysis 4.11

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 11 Haemoconcentration at term (Hb more than 130 g/L) (BY SUBGROUPS).

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Analysis 4.12

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 12 Haemoconcentration during second or third trimester (Hb more than 130 g/L) (ALL).

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Analysis 4.13

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 13 Haemoconcentration during second or third trimester (Hb more than 130 g/L) (BY SUBGROUPS).

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Analysis 4.16

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 16 Iron deficiency anaemia at term (based on two or more indicators) (ALL).

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Analysis 4.18

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 18 Side effects (any) (ALL).

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Analysis 4.19

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 19 Side effects (any) (BY SUBGROUPS).

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Analysis 4.20

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 20 Very low birthweight (less than 1500 g) (ALL).

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Analysis 4.21

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 21 Perinatal death (ALL).

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Analysis 4.27

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 27 Infant ferritin concentration at 6 months (ug/L) (ALL).

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Analysis 4.30

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 30 Very premature delivery (less than 34 weeks of gestation) (ALL).

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Analysis 4.31

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 31 Severe anaemia at term (Hb less than 70 g/L) (ALL).

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Analysis 4.32

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 32 Moderate anaemia at term (Hb more than 70g/L and less than 90 g/L) (ALL).

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Analysis 4.33

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 33 Severe anaemia at any time during second and third trimester (Hb less than 70 g/L) (ALL).

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Analysis 4.34

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 34 Moderate anaemia at any time during second or third trimester (ALL).

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Analysis 4.37

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 37 Antepartum haemorraghe (ALL).

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Analysis 4.41

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 41 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL).

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Analysis 4.42

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 42 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 100 g/L) (ALL).

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Analysis 4.43

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 43 Diarrhoea (ALL).

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Analysis 4.44

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 44 Constipation (ALL).

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Analysis 4.45

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 45 Nausea (ALL).

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Analysis 4.46

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 46 Heartburn (ALL).

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Analysis 4.47

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 47 Vomiting (ALL).

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Analysis 4.50

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 50 Placental abruption (ALL).

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Analysis 4.51

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 51 Premature rupture of membranes (ALL).

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Analysis 4.68

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 68 Ln (serum ferritin concentration) 4‐8 wk postpartum (not pre‐specified).

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Analysis 4.70

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 70 Low serum ferritin concentration at postpartum (4‐8 wk) (not pre‐specified).

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Analysis 4.71

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 71 High serum transferrin receptors at 6 weeks postpartum (not pre‐specified).

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Analysis 4.93

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 93 Caesarean delivery (not pre‐specified).

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Analysis 4.97

Comparison 4 Intermittent iron‐folic acid versus daily iron‐folic acid, Outcome 97 Haemoglobin concentration at 4‐8 weeks postpartum (not pre‐specified).

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Table 1. Methodological quality assessment of included trials

Trial	Randomisation	Allocation	Blinding	Completeness of data	Quality rating
Barton 1994	Adequate	Adequate	Participants and care provider blinded	Adequate. Less than 5% lost to follow up	HIGH
Batu 1976	Unclear method	Unclear	Unclear. Participants blinded. Care provider and outcome assessor not clear	Inadequate. 28% of women lost to follow up
Butler 1968	Adequate	Adequate	Inadequate. Participant and provider were blinded for treatment for groups 1 and 2.	Inadequate. More than 20% lost to follow up
Buytaert 1983	Adequate	Adequate	Inadequate. Open	Unclear	HIGH
Cantlie 1971	Unclear. Method not stated.	Unclear	Unclear	Unclear. Not reported
Chanarin 1971	Inadequate. Quasi randomised by sequence assignment	Inadequate	Participants and care provider blinded	Adequate. Less than 20% lost to follow up
Charoenlarp 1988	Adequate	Unclear	Unclear. Participants and outcome assessor blinded. Care provider unclear	Adequate
Chew 1996a	Adequate	Adequate by sealed envelopes	Inadequate. Participants, care provider and outcome assessor not blinded	Adequate. Less than 20% lost to follow up
Chew 1996b	Adequate	Adequate by sealed envelopes	Adequate. Participants and care provider not blinded. Outcome assessor blinded	Inadequate. More than 20% lost to follow up
Chisholm 1966	Unclear method	Adequate	Participants and care provider blinded	Adequate. Less than 20% lost to follow up
Christian 2003	Adequate. Cluster randomisation	Adequate. Coded assignment	Adequate. Participants, care providers and outcome assessors blinded	Inadequate. More than 20% lost to follow up	HIGH
Cogswell 2003	Adequate	Adequate	Adequate. Participants, care provider and outcome assessor blinded	Inadequate. More than 20% lost to follow up	HIGH
De Benaze 1989	Unclear method	Adequate	Adequate. Participants and care provider blinded	Adequate. Less than 20% lost to follow up
Ekstrom 2002	Adequate by cluster	Inadequate. Not used	Inadequate. Participants and care provider not blinded. Outcome assessor unclear	Inadequate. More than 20% lost to follow up
Eskeland 1997	Adequate	Adequate	Adequate. Participants, care provider and outcome assessor blinded	Inadequate. More than 20% lost to follow up	HIGH
Hankin 1963	Inadequate. Quasi randomised by alternate assignment by day of the week	Inadequate	Inadequate. Open	Adequate. Less than 5% excluded
Harvey 2007	Adequate	Adequate. Coded opaque bottles	Inadequate. Participants blinded. Care provider and outcome assessor not blinded	Adequate. No losses to follow up.	HIGH
Hemminki 1989	Adequate	Adequate. Sealed numbered envelopes.	Inadequate. Open to participants and care providers. Outcome assessor blind.	Adequate.	HIGH
Holly 1955	Unclear method	Unclear	Inadequate. Participants and care provider not blinded. Outcome assessor unclear	Unclear
Hood 1960	Unclear method	Unclear	Inadequate. Participants and care provider not blinded. Outcome assessor unclear	Adequate. Less than 20% lost to follow up
Kerr 1958	Adequate	Unclear	Inadequate. Participants blinded. Care provider not blinded. Outcome assessor unclear	Inadequate. More than 20% lost to follow up
Lee 2005	Adequate. Method unclear	Unclear	Unclear.	Adequate. Less than 20% lost to follow up
Liu 1996	Unclear method	Adequate by sealed envelopes	Inadequate. Participants and care provider not blinded. Outcome assessor blinded	Adequate. Less than 20% lost to follow up
Makrides 2003	Adequate	Adequate	Adequate. Participants and care provider blinded	Adequate. Less than 20% lost to follow up	HIGH
Meier 2003	Adequate. Stratified by age group	Unclear	Adequate. Participants and care provider blinded. Outcome assessor unclear	Inadequate. More than 20% lost to follow up
Menendez 1994	Unclear method	Inadequate	Inadequate. Participants and care provider not blinded. Outcome assessor blinded	Inadequate. More than 20% lost to follow up
Milman 1991	Unclear method	Unclear	Adequate. Participants and care provider blinded. Outcome assessor unclear	Adequate. Less than 20% lost to follow up
Mukhopadhyay 2004	Adequate. Block randomisation	Inadequate. Not used	Inadequate. Open to participants, and care providers. Outcome assessor unclear	Inadequate. More than 20% lost to follow up
Paintin 1966	Unclear method	Adequate by sequential numbers	Adequate. Participants and care provider blinded	Adequate. Less than 5% lost to follow up
Pita Martin 1999	Inadequate. Quasi randomised	Inadequate. Not used	Inadequate. Open	Inadequate. More than 20% lost to follow up
Preziosi 1997	Adequate	Adequate	Adequate. Participant and care provider blinded. Outcome assessor blinded	Unclear	HIGH
Pritchard 1958	Unclear method	Unclear	Inadequate. Open	Unclear
Puolakka 1980	Unclear method	Unclear	Inadequate. Open	Adequate. Less than 20% lost to follow up
Ridwan 1996	Adequate	Inadequate. Not used	Inadequate. Participants and care provider not blinded. Outcome assessor blinded	Inadequate. More than 20% lost to follow up
Robinson 1998	Quasi randomised by alternate numbers	Unclear	Inadequate. Participants and care provider not blinded	Inadequate. More than 20% lost to follow up
Romslo 1983	Unclear method	Unclear	Inadequate. Participants blinded. Care provider and outcome assessor not blinded	Adequate. Less than 20% lost to follow up
Siega‐Riz 2001	Adequate. Random number generator	Adequate	Adequate. Participants, care provider and outcome assessor blinded	Inadequate. More than 20% lost to follow up	HIGH
Svanberg 1975	Unclear method	Unclear	Adequate. Participants, care provider, and outcome assessor blinded	Adequate. Less than 20% lost to follow up
Taylor 1982	Unclear method	Unclear	Inadequate. Open	Adequate. less than 20% lost to follow up
Tura 1989	Adequate	Adequate	Inadequate. Open	Adequate. Less than 20% lost to follow up	HIGH
Van Eijk 1978	Unclear. Not stated	Inadequate. Not used	Inadequate.Open	Adequate. Less than 20% loss to follow up
Wallenburg 1983	Adequate	Adequate	Inadequate.Open	Adequate. Less than 20% lost to follow up	HIGH
Willoughby 1967	Unclear method	Unclear	Unclear	A. Adequate. Less than 20% lost to follow up
Wills 1947	Inadequate. Quasi randomised by alternate allocation	Inadequate. Not used	Adequate. Participants and care provider blinded. Outcome assessor blinded	Inadequate. More than 20% lost to follow up
Winichagoon 2003	Unclear method of cluster randomisation	Inadequate. Not used	Inadequate.Open	Inadequate. more than 20% lost to follow up
Young 2000	Adequate	Unclear	Inadequate. Participants and care provider not blinded. Outcome assessor unclear	Inadequate. More than 20% lost to follow up
Yu 1998	Inadequate. Quasi randomised	Inadequate	Inadequate.Open	Inadequate. More than 20% lost to follow up
Ziaei 2008	Adequate. Random numbers table	Adequate. Coded assignments	Adequate. Participants and care provider blinded. Outcome assessor unclear	Adequate. Less than 5% lost to follow up	HIGH
Ziaei 2007	Adequate. Table of random numbers	Adequate. Coded bottles	Adequate. participants and care providers blinded. Outcome assessor unclear	Adequate. Less than 5% lost to follow up.	HIGH

Table 1. Methodological quality assessment of included trials

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Comparison 1. Daily iron alone versus no intervention/placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Low birthweight (less than 2500 g) (ALL) Show forest plot	9	6275	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.61, 1.03]

2 Low birthweight (less than 2500 g) (BY SUBGROUPS) Show forest plot	9		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

2.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	7	5771	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.61, 1.08]
2.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	2	504	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.22, 1.38]
2.5 Non‐anaemic at start of supplementation	6	4452	Risk Ratio (M‐H, Random, 95% CI)	0.76 [0.46, 1.25]
2.6 Unspecified/mixed anaemic status at start of supplementation	3	1823	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.71, 0.94]
2.7 Daily lower dose (60 mg elemental iron or less)	7	3247	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.53, 1.18]
2.8 Daily higher dose (more than 60 mg elemental iron)	2	3028	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.45, 1.26]
3 Birthweight (g) (ALL) Show forest plot	10	5956	Mean Difference (IV, Random, 95% CI)	36.05 [‐4.84, 76.95]

4 Birthweight (g) (BY SUBGROUPS) Show forest plot	11		Mean Difference (IV, Random, 95% CI)	Subtotals only

4.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	9	5822	Mean Difference (IV, Random, 95% CI)	30.89 [‐13.87, 75.65]
4.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	2	251	Mean Difference (IV, Random, 95% CI)	39.72 [‐67.69, 147.12]
4.5 Non‐anaemic at start of supplementation	8	4496	Mean Difference (IV, Random, 95% CI)	29.32 [‐27.08, 85.71]
4.6 Unspecified/mixed anaemic status at start of supplementation	3	1577	Mean Difference (IV, Random, 95% CI)	52.33 [10.16, 94.51]
4.7 Daily low dose (60 mg elemental iron or less)	6	2804	Mean Difference (IV, Random, 95% CI)	37.22 [‐17.82, 92.27]
4.8 Daily higher dose (more than 60 mg elemental iron)	6	3382	Mean Difference (IV, Random, 95% CI)	17.99 [‐41.28, 77.26]
5 Premature delivery (less than 37 weeks of gestation) (ALL) Show forest plot	8	5730	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.67, 1.09]

6 Premature delivery (less 37 weeks of gestation) (BY SUBGROUPS) Show forest plot	8		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

6.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	6	2989	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.66, 1.20]
6.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	47	Risk Ratio (M‐H, Random, 95% CI)	0.32 [0.01, 7.48]
6.5 Non‐anaemic at start of supplementation	6	1775	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.54, 1.12]
6.6 Unspecified/mixed anaemic status at start of supplementation	1	1261	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.85, 1.28]
6.7 Daily lower dose (60 mg elemental iron or less)	6	3023	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.68, 1.18]
6.8 Daily higher dose (more than 60 mg elemental iron)	2	2707	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.48, 1.06]
7 Maternal Hb concentration at term (g/L) (ALL) Show forest plot	17	2463	Mean Difference (IV, Random, 95% CI)	8.83 [6.55, 11.11]

8 Maternal Hb concentration at term (g/L) (BY SUBGROUPS) Show forest plot	17		Mean Difference (IV, Random, 95% CI)	Subtotals only

8.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	13	2306	Mean Difference (IV, Random, 95% CI)	8.14 [5.61, 10.67]
8.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	3	130	Mean Difference (IV, Random, 95% CI)	10.24 [2.45, 18.04]
8.3 Unspecified/mixed gestational age at start of supplementation	1	27	Mean Difference (IV, Random, 95% CI)	14.0 [8.07, 19.93]
8.5 Non‐anaemic at start of supplementation	11	2002	Mean Difference (IV, Random, 95% CI)	7.77 [4.86, 10.69]
8.6 Unspecified/mixed anaemic status at start of supplementation	6	461	Mean Difference (IV, Random, 95% CI)	11.03 [7.51, 14.56]
8.7 Daily low dose (60 mg elemental iron or less)	8	1956	Mean Difference (IV, Random, 95% CI)	7.16 [4.14, 10.17]
8.8 Daily higher dose (more than 60 mg elemental iron)	9	507	Mean Difference (IV, Random, 95% CI)	10.94 [7.06, 14.82]
9 Anaemia at term (Hb less than 110 g/L) (ALL) Show forest plot	14	4390	Risk Ratio (M‐H, Random, 95% CI)	0.27 [0.17, 0.42]

10 Haemoconcentration at term (Hb more than 130 g/L) (ALL) Show forest plot	10	4643	Risk Ratio (M‐H, Random, 95% CI)	2.62 [1.21, 5.67]

11 Haemoconcentration at term (Hb more than 130 g/L) (BY SUBGROUPS) Show forest plot	10		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

11.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	5	4173	Risk Ratio (M‐H, Random, 95% CI)	1.99 [0.72, 5.45]
11.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	3	198	Risk Ratio (M‐H, Random, 95% CI)	3.94 [0.31, 50.47]
11.3 Unspecified/mixed gestational age at start of supplementation	2	272	Risk Ratio (M‐H, Random, 95% CI)	4.67 [2.53, 8.60]
11.5 Non‐anaemic at start of supplementation	5	4011	Risk Ratio (M‐H, Random, 95% CI)	1.73 [0.64, 4.66]
11.6 Unspecified/mixed anaemic status at start of supplementation	5	632	Risk Ratio (M‐H, Random, 95% CI)	4.03 [1.39, 11.72]
11.7 Daily low dose (60 mg elemental iron or less)	4	1317	Risk Ratio (M‐H, Random, 95% CI)	1.44 [0.54, 3.86]
11.8 Daily higher dose (more than 60 mg elemental iron)	6	3326	Risk Ratio (M‐H, Random, 95% CI)	3.55 [1.89, 6.66]
12 Haemoconcentration during second or third trimester (ALL) Show forest plot	10	4841	Risk Ratio (M‐H, Random, 95% CI)	2.27 [1.40, 3.70]

13 Haemoconcentration during second or third trimester (BY SUBGROUPS) Show forest plot	10		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

13.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	7	4522	Risk Ratio (M‐H, Random, 95% CI)	2.62 [1.49, 4.60]
13.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	47	Risk Ratio (M‐H, Random, 95% CI)	1.44 [0.72, 2.86]
13.3 Unspecified/mixed gestational age at start of supplementation	2	272	Risk Ratio (M‐H, Random, 95% CI)	1.94 [0.30, 12.29]
13.5 Non‐anaemic at start of supplementation	6	4088	Risk Ratio (M‐H, Random, 95% CI)	2.10 [1.13, 3.90]
13.6 Unspecified/mixed anaemic status at start of supplementation	4	753	Risk Ratio (M‐H, Random, 95% CI)	2.67 [0.99, 7.17]
13.7 Daily low dose (60 mg elemental iron or less)	5	1655	Risk Ratio (M‐H, Random, 95% CI)	2.35 [1.21, 4.57]
13.8 Daily higher dose (more than 60 mg elemental iron)	5	3186	Risk Ratio (M‐H, Random, 95% CI)	2.14 [1.05, 4.37]
14 Iron deficiency at term (as defined by two or more indicators) (ALL) Show forest plot	6	1108	Risk Ratio (M‐H, Random, 95% CI)	0.44 [0.27, 0.70]

15 Iron deficiency at term (as defined by two or more indicators) (BY SUBGROUPS) Show forest plot	6		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

15.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	4	867	Risk Ratio (M‐H, Random, 95% CI)	0.56 [0.35, 0.90]
15.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	2	241	Risk Ratio (M‐H, Random, 95% CI)	0.28 [0.17, 0.44]
15.5 Non‐anaemic at start of supplementation	4	944	Risk Ratio (M‐H, Random, 95% CI)	0.60 [0.41, 0.90]
15.6 Unspecified/mixed anaemic status at start of supplementation	2	164	Risk Ratio (M‐H, Random, 95% CI)	0.14 [0.07, 0.29]
15.7 Daily low dose (60 mg elemental iron or less)	4	944	Risk Ratio (M‐H, Random, 95% CI)	0.60 [0.41, 0.90]
15.8 Daily higher dose (more than 60 mg elemental iron)	2	164	Risk Ratio (M‐H, Random, 95% CI)	0.14 [0.07, 0.29]
16 Iron deficiency anaemia at term (ALL) Show forest plot	6	1667	Risk Ratio (M‐H, Random, 95% CI)	0.33 [0.16, 0.69]

17 Iron deficiency anaemia at term (BY SUBGROUPS) Show forest plot	6		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

17.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	5	1622	Risk Ratio (M‐H, Random, 95% CI)	0.37 [0.18, 0.76]
17.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	45	Risk Ratio (M‐H, Random, 95% CI)	0.07 [0.00, 1.13]
17.5 Non‐anaemic at start of supplementation	5	1547	Risk Ratio (M‐H, Random, 95% CI)	0.39 [0.20, 0.74]
17.6 Unspecified/mixed anaemic status at start of supplementation	1	120	Risk Ratio (M‐H, Random, 95% CI)	0.04 [0.00, 0.72]
17.7 Daily low dose (60 mg elemental iron or less)	5	1547	Risk Ratio (M‐H, Random, 95% CI)	0.39 [0.20, 0.74]
17.8 Daily higher dose (more than 60 mg elemental iron)	1	120	Risk Ratio (M‐H, Random, 95% CI)	0.04 [0.00, 0.72]
18 Side‐effects (Any) (ALL) Show forest plot	8	3667	Risk Ratio (M‐H, Random, 95% CI)	3.92 [1.21, 12.64]

19 Side‐effects (Any) (BY SUBGROUPS) Show forest plot	8		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

19.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	4	3034	Risk Ratio (M‐H, Random, 95% CI)	3.69 [0.42, 32.71]
19.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	3	428	Risk Ratio (M‐H, Random, 95% CI)	1.75 [0.99, 3.08]
19.3 Unspecified/mixed gestational age at start of supplementation	1	205	Risk Ratio (M‐H, Random, 95% CI)	62.79 [3.89, 1013.31]
19.5 Non‐anaemic at start of supplementation	4	2897	Risk Ratio (M‐H, Random, 95% CI)	3.27 [0.39, 27.31]
19.6 Unspecified/mixed anaemic status at start of supplementation	4	770	Risk Ratio (M‐H, Random, 95% CI)	3.94 [1.09, 14.28]
19.7 Daily low dose (60 mg elemental iron or less)	4	566	Risk Ratio (M‐H, Random, 95% CI)	1.36 [0.99, 1.87]
19.8 Daily higher dose (more than 60 mg elemental iron)	5	3148	Risk Ratio (M‐H, Random, 95% CI)	12.12 [1.76, 83.43]
20 Very low birthweight (less than 1500 g) (ALL) Show forest plot	5	2687	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.31, 1.74]

21 Perinatal death (ALL) Show forest plot	3	5036	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.67, 1.29]

24 Infant Hb concentration at 3 months (g/L) (ALL) Show forest plot	1	197	Mean Difference (IV, Random, 95% CI)	0.0 [‐3.21, 3.21]

25 Infant serum ferritin concentration at 3 months (ug/L) (ALL) Show forest plot	1	197	Mean Difference (IV, Random, 95% CI)	19.0 [2.75, 35.25]

26 Infant Hb concentration at 6 months (g/L) (ALL) Show forest plot	2	533	Mean Difference (IV, Random, 95% CI)	‐1.25 [‐8.10, 5.59]

27 Infant serum ferritin concentration at 6 months (ug/L) (ALL) Show forest plot	1	197	Mean Difference (IV, Random, 95% CI)	11.0 [4.37, 17.63]

29 Admission to special care unit (ALL) Show forest plot	2	2805	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.73, 1.23]

30 Very premature delivery (less than 34 weeks' gestation) (ALL) Show forest plot	4	1417	Risk Ratio (M‐H, Random, 95% CI)	0.44 [0.16, 1.24]

31 Severe anaemia at term (Hb less than 70 g/L) (ALL) Show forest plot	8	1751	Risk Ratio (M‐H, Random, 95% CI)	4.83 [0.23, 99.88]

32 Moderate anaemia at term (Hb more than 70 g/L and less than 90 g/L) (ALL) Show forest plot	9	1868	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.55, 1.62]

33 Severe anaemia at any time during second and third trimester (ALL) Show forest plot	9	2089	Risk Ratio (M‐H, Random, 95% CI)	0.48 [0.01, 34.52]

34 Moderate anaemia at any time during second or third trimester (ALL) Show forest plot	10	2266	Risk Ratio (M‐H, Random, 95% CI)	0.42 [0.19, 0.92]

35 Infection during pregnancy (including urinary tract infections) (ALL) Show forest plot	2	3421	Risk Ratio (M‐H, Random, 95% CI)	1.16 [0.83, 1.63]

36 Puerperal infection (ALL) Show forest plot	2	2169	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.25, 2.10]

37 Antepartum haemorraghe (ALL) Show forest plot	2	1157	Risk Ratio (M‐H, Random, 95% CI)	1.48 [0.51, 4.31]

38 Postpartum haemorraghe (ALL) Show forest plot	5	1554	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.51, 1.78]

39 Transfusion provided (ALL) Show forest plot	3	3453	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.38, 0.96]

40 Haemoglobin concentration within one month postpartum (ALL) Show forest plot	6	904	Mean Difference (IV, Random, 95% CI)	7.08 [4.70, 9.47]

41 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL) Show forest plot	7	1094	Risk Ratio (M‐H, Random, 95% CI)	0.06 [0.00, 1.05]

42 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 100 g/L) (ALL) Show forest plot	4	831	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.12, 2.51]

43 Diarrhoea (ALL) Show forest plot	3	1088	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.32, 0.93]

44 Constipation (ALL) Show forest plot	4	1495	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.62, 1.43]

45 Nausea (ALL) Show forest plot	4	1377	Risk Ratio (M‐H, Random, 95% CI)	1.21 [0.72, 2.03]

46 Heartburn (ALL) Show forest plot	3	1323	Risk Ratio (M‐H, Random, 95% CI)	1.19 [0.86, 1.66]

47 Vomiting (ALL) Show forest plot	4	1392	Risk Ratio (M‐H, Random, 95% CI)	0.88 [0.59, 1.30]

48 Maternal death (death while pregnant or within 42 days of termination of pregnancy) (ALL) Show forest plot	1	47	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

49 Maternal wellbeing/satisfaction (ALL) Show forest plot	2	2604	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.91, 1.09]

50 Placental abruption (ALL) Show forest plot	2	2169	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.32, 4.06]

51 Premature rupture of membranes (ALL) Show forest plot	1	727	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.74, 1.34]

52 Pre‐eclampsia (ALL) Show forest plot	2	774	Risk Ratio (M‐H, Random, 95% CI)	2.58 [0.81, 8.22]

91 Small for gestational age (less than 10th percentile weight at birth for gestational age) (not pre‐specified) Show forest plot	4	2511	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.58, 1.30]

93 Cesarean delivery (not pre‐specified) Show forest plot	7	4283	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.78, 1.13]

94 Birth length in cm (not pre‐specified) Show forest plot	5	2140	Mean Difference (IV, Random, 95% CI)	0.38 [0.10, 0.65]

95 Forceps or vacuum delivery (not pre‐specified) Show forest plot	2	477	Risk Ratio (M‐H, Random, 95% CI)	1.50 [0.94, 2.40]

96 Breastfeeding at least 4 months (not pre‐specified) Show forest plot	1	48	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.89, 1.13]

97 Haemoglobin concentration at 4‐8 weeks' postpartum (g/L) (not pre‐specified) Show forest plot	10	1188	Mean Difference (IV, Random, 95% CI)	5.13 [0.24, 10.02]

98 Apgar score < 7 at 5 minutes (not pre‐specified) Show forest plot	2	475	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.17, 3.28]

99 Apgar Score at 5 min (not pre‐specified) Show forest plot	2	228	Mean Difference (IV, Random, 95% CI)	0.27 [‐0.07, 0.62]

Comparison 1. Daily iron alone versus no intervention/placebo

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Comparison 2. Intermittent iron alone versus daily iron alone

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
3 Birthweight (ALL) Show forest plot	1	41	Mean Difference (IV, Random, 95% CI)	‐68.0 [‐398.33, 262.33]

5 Premature delivery (less than 37 weeks of gestation) (ALL) Show forest plot	1	41	Risk Ratio (M‐H, Random, 95% CI)	0.46 [0.02, 8.96]

12 Haemoconcentration during second or third trimester (Hb more than 130 g/L) (ALL) Show forest plot	2	64	Risk Ratio (M‐H, Random, 95% CI)	0.54 [0.18, 1.58]

33 Severe anaemia at any time during second and third trimester (Hb less than 70 g/L) (ALL) Show forest plot	2	64	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

34 Moderate anaemia at any time during second or third trimester (ALL) Show forest plot	2	64	Risk Ratio (M‐H, Random, 95% CI)	2.42 [0.16, 35.56]

Comparison 2. Intermittent iron alone versus daily iron alone

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Comparison 3. Daily iron‐folic acid versus no intervention/placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Low birthweight (less than 2500 g) (ALL) Show forest plot	2	1368	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.28, 4.02]

2 Low birthweight (less than 2500 g) (BY SUBGROUPS) Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

2.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	1368	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.28, 4.02]
2.6 Unspecified/mixed anaemic status at start of supplementation	2	1368	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.28, 4.02]
2.7 Daily low dose (60 mg elemental iron or less)	1	1320	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.69, 0.91]
2.8 Daily higher dose (more than 60 mg elemental iron)	1	48	Risk Ratio (M‐H, Random, 95% CI)	5.0 [0.25, 98.96]
3 Birthweight (ALL) Show forest plot	2	1365	Mean Difference (IV, Random, 95% CI)	57.73 [7.66, 107.79]

4 Birthweight (BY SUBGROUPS) Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

4.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	1365	Mean Difference (IV, Random, 95% CI)	57.73 [7.66, 107.79]
4.6 Unspecified/mixed anaemic status at start of supplementation	2	1365	Mean Difference (IV, Random, 95% CI)	57.73 [7.66, 107.79]
4.7 Daily low dose (60 mg elemental iron or less)	1	1320	Mean Difference (IV, Random, 95% CI)	65.0 [17.46, 112.54]
4.8 Daily higher dose (more than 60 mg elemental iron)	1	45	Mean Difference (IV, Random, 95% CI)	‐32.0 [‐213.62, 149.62]
5 Premature delivery (less than 37 weeks of gestation) (ALL) Show forest plot	3	1497	Risk Ratio (M‐H, Random, 95% CI)	1.55 [0.40, 6.00]

6 Premature delivery (less than 37 weeks of gestation) (BY SUB GROUPS) Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

6.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	1362	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.92, 1.39]
6.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.6 Unspecified/mixed anaemic status at start of supplementation	2	1449	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.92, 1.39]
6.7 Daily low dose (60 mg elemental iron or less)	2	1449	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.92, 1.39]
7 Haemoglobin concentration at term (ALL) Show forest plot	4	179	Mean Difference (IV, Random, 95% CI)	12.00 [2.93, 21.07]

8 Haemoglobin concentration at term (BY SUBGROUPS) Show forest plot	4		Mean Difference (IV, Random, 95% CI)	Subtotals only

8.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	93	Mean Difference (IV, Random, 95% CI)	15.65 [11.84, 19.46]
8.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	2	86	Mean Difference (IV, Random, 95% CI)	7.92 [‐11.68, 27.52]
8.5 Non‐anaemic at start of supplementation	1	48	Mean Difference (IV, Random, 95% CI)	17.10 [8.44, 25.76]
8.6 Unspecified/mixed anaemic status at start of supplementation	3	131	Mean Difference (IV, Random, 95% CI)	10.47 [‐1.07, 22.00]
8.7 Daily low dose (60 mg elemental iron or less)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
8.8 Daily higher dose (more than 60 mg elemental iron)	4	179	Mean Difference (IV, Random, 95% CI)	12.00 [2.93, 21.07]
9 Anaemia at term (Hb less than 110 g/L) (ALL) Show forest plot	3	346	Risk Ratio (M‐H, Random, 95% CI)	0.27 [0.12, 0.56]

10 Haemoconcentration at term (Hb more than 130 g/L) (ALL) Show forest plot	3	353	Risk Ratio (M‐H, Random, 95% CI)	1.74 [0.34, 8.94]

11 Haemoconcentration at term (Hb more than 130 g/L) (BY SUBGROUPS) Show forest plot	3		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

11.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	1	75	Risk Ratio (M‐H, Random, 95% CI)	3.37 [0.19, 60.03]
11.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	3	298	Risk Ratio (M‐H, Random, 95% CI)	1.97 [0.32, 12.08]
11.6 Unspecified/mixed anaemic status at start of supplementation	1	131	Risk Ratio (M‐H, Random, 95% CI)	4.31 [0.26, 70.41]
11.7 Daily low dose (60 mg elemental iron or less)	1	131	Risk Ratio (M‐H, Random, 95% CI)	4.31 [0.26, 70.41]
11.8 Daily higher dose (more than 60 mg elemental iron)	2	222	Risk Ratio (M‐H, Random, 95% CI)	1.28 [0.24, 6.78]
12 Haemoconcentration during second or third trimester (ALL) Show forest plot	2	446	Risk Ratio (M‐H, Random, 95% CI)	1.78 [0.63, 5.04]

13 Haemoconcentration during second or third trimester (BY SUBGROUPS) Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

13.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	390	Risk Ratio (M‐H, Random, 95% CI)	1.45 [0.33, 6.32]
13.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	76	Risk Ratio (M‐H, Random, 95% CI)	1.34 [0.50, 3.56]
13.3 Unspecified/mixed gestational age at start of supplementation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.5 Non‐anaemic at start of supplementation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.6 Unspecified/mixed anaemic status at start of supplementation	2	446	Risk Ratio (M‐H, Random, 95% CI)	1.78 [0.63, 5.04]
13.7 Daily low dose (60 mg elemental iron or less)	2	446	Risk Ratio (M‐H, Random, 95% CI)	1.78 [0.63, 5.04]
13.8 Daily higher dose (more than 60 mg elemental iron)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Iron deficiency at term (as defined by two or more indicators) (ALL) Show forest plot	1	131	Risk Ratio (M‐H, Random, 95% CI)	0.24 [0.06, 0.99]

15 Iron deficiency at term (as defined by two or more indicators) (BY SUBGROUPS) Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

15.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	1	75	Risk Ratio (M‐H, Random, 95% CI)	0.12 [0.01, 1.10]
15.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	76	Risk Ratio (M‐H, Random, 95% CI)	0.36 [0.08, 1.63]
15.5 Non‐anaemic at start of supplementation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.6 Unspecified/mixed anaemic status at start of supplementation	1	131	Risk Ratio (M‐H, Random, 95% CI)	0.24 [0.06, 0.99]
15.7 Daily low dose (60 mg elemental iron or less)	1	131	Risk Ratio (M‐H, Random, 95% CI)	0.24 [0.06, 0.99]
15.8 Daily higher dose (more than 60 mg elemental iron)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Iron deficiency anaemia at term (ALL) Show forest plot	1	131	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.17, 1.09]

17 Iron deficiency anaemia at term (BY SUBGROUPS) Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

17.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	1	75	Risk Ratio (M‐H, Random, 95% CI)	0.36 [0.12, 1.12]
17.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	76	Risk Ratio (M‐H, Random, 95% CI)	0.5 [0.18, 1.40]
17.5 Non‐anaemic at start of supplementation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.6 Unspecified/mixed anaemic status at start of supplementation	1	131	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.17, 1.09]
17.7 Daily low dose (60 mg elemental iron or less)	1	131	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.17, 1.09]
17.8 Daily higher dose (more than 60 mg elemental iron)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Side effects (Any) (ALL) Show forest plot	1	456	Risk Ratio (M‐H, Random, 95% CI)	44.32 [2.77, 709.09]

20 Very low birthweight (less than 1500 g) (ALL) Show forest plot	1	48	Risk Ratio (M‐H, Random, 95% CI)	5.0 [0.25, 98.96]

21 Perinatal death (ALL) Show forest plot	3	1862	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.58, 1.17]

29 Admission to special care unit (ALL) Show forest plot	1	48	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

30 Very premature delivery (less than 34 weeks' gestation) (ALL) Show forest plot	2	92	Risk Ratio (M‐H, Random, 95% CI)	5.0 [0.25, 98.96]

31 Severe anaemia at term (Hb less than 70 g/L) (ALL) Show forest plot	3	180	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

32 Moderate anaemia at term (Hb more than 70g/L and less than 90 g/L) (ALL) Show forest plot	3	180	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

33 Severe anaemia at any time during second and third trimester (Hb less than 70 g/L) (ALL) Show forest plot	4	523	Risk Ratio (M‐H, Random, 95% CI)	0.11 [0.01, 0.83]

34 Moderate anaemia at any time during second or third trimester (ALL) Show forest plot	4	523	Risk Ratio (M‐H, Random, 95% CI)	0.34 [0.11, 1.04]

35 Infection during pregnancy (including urinary tract infections) (ALL) Show forest plot	1	48	Risk Ratio (M‐H, Random, 95% CI)	1.0 [0.15, 6.53]

36 Puerperal infection (ALL) Show forest plot	1	2863	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.13, 2.28]

37 Antepartum haemorrhage (ALL) Show forest plot	2	145	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.22, 7.12]

38 Postpartum haemorrhage (ALL) Show forest plot	1	68	Risk Ratio (M‐H, Random, 95% CI)	0.12 [0.00, 2.71]

40 Haemoglobin concentration within one month postpartum (ALL) Show forest plot	1	45	Mean Difference (IV, Random, 95% CI)	10.40 [4.03, 16.77]

41 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL) Show forest plot	3	525	Risk Ratio (M‐H, Random, 95% CI)	0.05 [0.00, 0.76]

42 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 100 g/L) (ALL) Show forest plot	3	525	Risk Ratio (M‐H, Random, 95% CI)	0.34 [0.17, 0.69]

48 Maternal death (death while pregnant or within 42 days of termination of pregnancy) (ALL) Show forest plot	1	131	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

50 Placental abruption (ALL) Show forest plot	1	2863	Risk Ratio (M‐H, Random, 95% CI)	8.19 [0.49, 138.16]

52 Pre‐eclampsia (ALL) Show forest plot	1	48	Risk Ratio (M‐H, Random, 95% CI)	3.00 [0.13, 70.16]

91 Small for gestational age (less than 10th percentile weight at birth for gestational age) (not pre‐specified) Show forest plot	1	1318	Risk Ratio (M‐H, Random, 95% CI)	0.88 [0.80, 0.97]

92 Oedema during pregnancy (not pre‐specified) Show forest plot	1	67	Risk Ratio (M‐H, Random, 95% CI)	2.82 [0.99, 8.09]

93 Caesarean delivery (not pre‐specified) Show forest plot	1	97	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.22, 3.13]

94 Birth length in cm (not pre‐specified) Show forest plot	1	1320	Mean Difference (IV, Random, 95% CI)	0.20 [‐0.06, 0.46]

97 Haemoglobin concentration at 4‐8 weeks postpartum (not prespecified) Show forest plot	3	526	Mean Difference (IV, Random, 95% CI)	4.88 [‐0.85, 10.62]

Comparison 3. Daily iron‐folic acid versus no intervention/placebo

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Comparison 4. Intermittent iron‐folic acid versus daily iron‐folic acid

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Low birthweight (less than 2500 g) (ALL) Show forest plot	4	730	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.58, 1.91]

2 Low birthweight (less than 2500 g) (BY SUBGROUPS) Show forest plot	4		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

2.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	455	Risk Ratio (M‐H, Random, 95% CI)	1.29 [0.55, 3.01]
2.3 Unspecified/mixed gestational age at start of supplementation	2	275	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.36, 1.99]
2.5 Non‐anaemic at start of supplementation	1	80	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.36, 4.32]
2.7 Daily low dose (60 mg elemental iron or less)	3	650	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.50, 1.97]
2.8 Daily higher dose (more than 60 mg elemental iron)	1	80	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.36, 4.32]
3 Birthweight (ALL) Show forest plot	4	730	Mean Difference (IV, Random, 95% CI)	‐7.10 [‐67.20, 53.01]

4 Birthweight (BY SUBGROUPS) Show forest plot	4		Mean Difference (IV, Random, 95% CI)	Subtotals only

4.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	455	Mean Difference (IV, Random, 95% CI)	1.19 [‐70.50, 72.87]
4.3 Unspecified/mixed gestational age at start of supplementation	2	275	Mean Difference (IV, Random, 95% CI)	‐26.71 [‐137.00, 83.58]
4.5 Non‐anaemic at start of supplementation	1	80	Mean Difference (IV, Random, 95% CI)	0.0 [‐154.95, 154.95]
4.7 Daily low dose (60 mg elemental iron or less)	3	650	Mean Difference (IV, Random, 95% CI)	‐8.36 [‐73.56, 56.85]
4.8 Daily higher dose (more than 60 mg elemental iron)	1	80	Mean Difference (IV, Random, 95% CI)	0.0 [‐154.95, 154.95]
5 Premature delivery (less than 37 weeks of gestation) (ALL) Show forest plot	1	80	Risk Ratio (M‐H, Random, 95% CI)	2.0 [0.39, 10.31]

7 Haemoglobin concentration at term (ALL) Show forest plot	3	475	Mean Difference (IV, Random, 95% CI)	‐0.83 [‐4.74, 3.08]

8 Haemoglobin concentration at term (BY SUBGROUPS) Show forest plot	3		Mean Difference (IV, Random, 95% CI)	Subtotals only

8.3 Unspecified/mixed gestational age at start of supplementation	2	301	Mean Difference (IV, Random, 95% CI)	‐2.19 [‐6.85, 2.47]
8.7 Daily low dose (60 mg elemental iron or less)	3	422	Mean Difference (IV, Random, 95% CI)	‐0.10 [‐5.15, 4.95]
8.8 Daily higher dose (more than 60 mg elemental iron)	1	109	Mean Difference (IV, Random, 95% CI)	‐0.82 [‐4.99, 3.35]
9 Anaemia at term (Hb < 110 g/L) (ALL) Show forest plot	3	475	Risk Ratio (M‐H, Random, 95% CI)	1.20 [0.78, 1.83]

10 Haemoconcentration at term (Hb more than 130 g/L) (ALL) Show forest plot	3	475	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.47, 1.82]

11 Haemoconcentration at term (Hb more than 130 g/L) (BY SUBGROUPS) Show forest plot	3		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

11.7 Daily low dose (60 mg elemental iron or less)	3	422	Risk Ratio (M‐H, Random, 95% CI)	1.24 [0.42, 3.66]
11.8 Daily higher dose (more than 60 mg elemental iron)	1	109	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.19, 2.11]
12 Haemoconcentration during second or third trimester (Hb more than 130 g/L) (ALL) Show forest plot	6	1111	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.24, 0.77]

13 Haemoconcentration during second or third trimester (Hb more than 130 g/L) (BY SUBGROUPS) Show forest plot	6		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

13.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation	2	250	Risk Ratio (M‐H, Random, 95% CI)	0.52 [0.26, 1.01]
13.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	166	Risk Ratio (M‐H, Random, 95% CI)	0.24 [0.10, 0.55]
13.3 Unspecified/mixed gestational age at start of supplementation	3	695	Risk Ratio (M‐H, Random, 95% CI)	0.46 [0.13, 1.65]
13.4 Anaemic at start of supplementation (Hb <110 g/L if in first or <105 g/L if in second trimester)	1	47	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.5 Non‐anaemic at start of supplementation	1	80	Risk Ratio (M‐H, Random, 95% CI)	0.6 [0.15, 2.34]
13.6 Unspecified/mixed anaemic status at start of supplementation	4	966	Risk Ratio (M‐H, Random, 95% CI)	0.41 [0.21, 0.80]
13.7 Daily low dose (60 mg elemental iron or less)	5	953	Risk Ratio (M‐H, Random, 95% CI)	0.41 [0.20, 0.82]
13.8 Daily higher dose (more than 60 mg elemental iron)	2	247	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.42, 1.31]
16 Iron deficiency anaemia at term (based on two or more indicators) (ALL) Show forest plot	1	156	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.08, 6.63]

18 Side effects (any) (ALL) Show forest plot	7	1307	Risk Ratio (M‐H, Random, 95% CI)	0.69 [0.45, 1.04]

19 Side effects (any) (BY SUBGROUPS) Show forest plot	7		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

19.1 Early gestational age (less than 20 weeks or pre‐pregnancy) at start of supplementation	1	80	Risk Ratio (M‐H, Random, 95% CI)	0.2 [0.08, 0.53]
19.2 Late gestational age (20 weeks or more of gestation) at start of supplementation	1	172	Risk Ratio (M‐H, Random, 95% CI)	1.0 [0.79, 1.27]
19.3 Unspecified/mixed gestational age at start of supplementation	5	1055	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.42, 1.26]
19.4 Non‐anaemic at start of supplementation	1	80	Risk Ratio (M‐H, Random, 95% CI)	0.2 [0.08, 0.53]
19.7 Daily low dose (60 mg elemental iron or less)	6	1171	Risk Ratio (M‐H, Random, 95% CI)	0.92 [0.71, 1.19]
19.8 Daily higher dose (more than 60 mg elemental iron)	2	253	Risk Ratio (M‐H, Random, 95% CI)	0.14 [0.07, 0.25]
20 Very low birthweight (less than 1500 g) (ALL) Show forest plot	4	737	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

21 Perinatal death (ALL) Show forest plot	1	80	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

27 Infant ferritin concentration at 6 months (ug/L) (ALL) Show forest plot	1	88	Mean Difference (IV, Random, 95% CI)	0.09 [0.05, 0.13]

30 Very premature delivery (less than 34 weeks of gestation) (ALL) Show forest plot	1	111	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.06, 15.31]

31 Severe anaemia at term (Hb less than 70 g/L) (ALL) Show forest plot	4	555	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

32 Moderate anaemia at term (Hb more than 70g/L and less than 90 g/L) (ALL) Show forest plot	3	475	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.07, 16.23]

33 Severe anaemia at any time during second and third trimester (Hb less than 70 g/L) (ALL) Show forest plot	6	1240	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

34 Moderate anaemia at any time during second or third trimester (ALL) Show forest plot	6	1111	Risk Ratio (M‐H, Random, 95% CI)	2.54 [0.63, 10.17]

37 Antepartum haemorraghe (ALL) Show forest plot	1	110	Risk Ratio (M‐H, Random, 95% CI)	1.0 [0.06, 15.59]

41 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL) Show forest plot	1	169	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.04, 4.64]

42 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 100 g/L) (ALL) Show forest plot	1	169	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.26, 4.95]

43 Diarrhoea (ALL) Show forest plot	4	553	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.38, 2.34]

44 Constipation (ALL) Show forest plot	4	553	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.48, 2.06]

45 Nausea (ALL) Show forest plot	5	854	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.30, 1.16]

46 Heartburn (ALL) Show forest plot	3	473	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.29, 2.06]

47 Vomiting (ALL) Show forest plot	5	854	Risk Ratio (M‐H, Random, 95% CI)	1.44 [0.82, 2.53]

50 Placental abruption (ALL) Show forest plot	1	110	Risk Ratio (M‐H, Random, 95% CI)	0.33 [0.01, 8.01]

51 Premature rupture of membranes (ALL) Show forest plot	1	80	Risk Ratio (M‐H, Random, 95% CI)	0.33 [0.01, 7.95]

68 Ln (serum ferritin concentration) 4‐8 wk postpartum (not pre‐specified) Show forest plot	1	160	Mean Difference (IV, Random, 95% CI)	‐0.13 [‐0.42, 0.16]

70 Low serum ferritin concentration at postpartum (4‐8 wk) (not pre‐specified) Show forest plot	1	146	Risk Ratio (M‐H, Random, 95% CI)	1.19 [0.40, 3.57]

71 High serum transferrin receptors at 6 weeks postpartum (not pre‐specified) Show forest plot	1	146	Risk Ratio (M‐H, Random, 95% CI)	0.69 [0.36, 1.33]

93 Caesarean delivery (not pre‐specified) Show forest plot	1	80	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.38, 2.07]

97 Haemoglobin concentration at 4‐8 weeks postpartum (not pre‐specified) Show forest plot	1	146	Mean Difference (IV, Random, 95% CI)	2.0 [‐3.86, 7.86]

Comparison 4. Intermittent iron‐folic acid versus daily iron‐folic acid

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