Guideline / position statementindependent cross-checkabstract checked★ key study I-SUP-105 in-depth review
WHO: iron and folic acid for every pregnancy
Daily iron and folic acid supplementation during pregnancy (WHO e-Library of Evidence for Nutrition Actions, intervention page, last updated 26 July 2024)
Overview
World Health Organization. WHO eLENA (web page) 2024
WHO recommends that pregnant women take daily iron (30-60 mg) and folic acid (0.4 mg), starting folic acid ideally before conception.
Does the study support the specific claim? No · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
To state WHO's recommendation on iron and folic acid in pregnancy.
- How was the study done?
Guideline recommendation based on systematic reviews.
- How many people, animals or samples were studied?
Not applicable.
- What was actually found?
Daily iron and folic acid recommended for all pregnant women.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Taking iron and folic acid in pregnancy is standard, recommended care.
- What are the study's limitations?
Summary page only; national practice varies.
- What does it say about Elawady's specific claim?
Directly contradicts banning iron or folic acid in pregnancy.
- Do the results apply to Germany and Europe?
Global.
- What can explicitly not be concluded from this study?
Does not replace individual medical advice.
Scientific in-depth review
1. Full reference
- Authors
- World Health Organization
- Journal
- WHO eLENA (web page)
- Year
- 2024
- Identifier
- Verification
- verified – WHO eLENA web page fetched 2026-10-26 (HTTP 200); recommendation text read
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
WHO guideline process (declarations of interest not reviewed here)
2. Research question
Should pregnant women receive daily oral iron and folic acid?
3. Study design and population
- Study design
- Guideline / position statement – WHO guideline recommendation summary (eLENA intervention page; recommendation from 'WHO recommendations on antenatal care for a positive pregnancy experience', 2016)
- Population
Pregnant women
- Country
Global
- Period
Page last updated 26 July 2024
- Sample size
Not applicable
- Inclusion and exclusion criteria
Not applicable
4. Methods and endpoints
- Exposure / intervention
Daily oral iron (30-60 mg elemental) and folic acid (400 micrograms)
- Comparator
No supplementation
- Endpoints
Maternal anaemia, puerperal sepsis, low birth weight, preterm birth, neural tube defects
- Statistical methods
Not applicable (guideline)
5. Actual results
- Results
Page states that more than 40% of pregnant women worldwide are estimated to be anaemic, at least half due to iron deficiency. WHO recommendation: daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron and 400 micrograms (0.4 mg) folic acid is recommended for pregnant women to prevent maternal anaemia, puerperal sepsis, low birth weight and preterm birth; folic acid should be commenced as early as possible (ideally before conception) to prevent neural tube defects. The recommendation supersedes the 2012 WHO guideline. Evidence base listed: Pena-Rosas 2015 Cochrane review.
- Absolute risks
Not applicable
- Authors' conclusion
Daily iron and folic acid are recommended for all pregnant women (WHO).
6. Strengths
- Official WHO recommendation
- Global scope
7. Weaknesses
- Web summary; full guideline PDF and GRADE tables not read here
- Evidence base cited is the 2015 Cochrane version
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Guideline; quality of development not appraised (AGREE II not applied).
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
States the medically accepted global position that directly contradicts C-SUP-09 and C-SUP-10.
11. Independent contrary findings
Some European guidelines recommend selective rather than universal iron (not verified here).
12. Transferability to Germany and Europe
Global WHO guidance; national European practice may be selective.
13. Overall methodological judgement
Authoritative statement of standard care.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Status of national Egyptian antenatal guidance (not fetched).
15. Linked fact checks
- There is no such thing as iron supplements: they are forbidden even for a pregnant woman with anaemia, because a diet that needs supplements is deficient. – Studies contradicting or limiting the claim
- No one needs vitamins or supplements: 'there is no such thing as dietary supplements', the body makes its own vitamins, and vitamins are on the forbidden list. – Studies contradicting or limiting the claim