human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Previous studies have found that there is a correlation between mothers ' haemoglobin concentration or packed cell volume and infants ' birth weight , and that iron supplementation increases mothers ' haemoglobin concentration . The purpose of this study , using the data of a large r and omised trial on iron prophylaxis during pregnancy , was to find out whether iron supplementation causes fetal growth to deteriorate . At their first antenatal visit , 2912 pregnant women were r and omised into non-routine iron and routine iron supplementation . The mean length of gestation was shorter in the non-routine group . Birth weight did not differ between the groups , but due to longer gestations boys in the group receiving routine iron were taller than in the non-routine group . In both groups , whether studied by various values of packed cell volume or correlation coefficients , the lower the packed cell volume , the heavier and taller the infant and heavier the placenta . These negative correlations could be seen even with a packed cell volume measured early in pregnancy . St and ardising for blood pressure did not influence the correlation coefficients . The correlation between a high ratio for packed cell volume and poor fetal growth thus may not be caused by iron supplementation , nor mediated by blood pressure , but by some other mechanism Background Gastrointestinal irritability can deter pregnant women from starting or continuing prenatal multivitamin supplementation . In a previous study , suboptimal tolerability was observed among pregnant women taking a large tablet ( 18 mm × 8 mm × 8 mm ) multivitamin with high elemental iron content ( 60 mg as ferrous fumarate ) . The objective of the present study was to compare rates of adherence and reported adverse events among pregnant women who were r and omized to commence supplementation with a small-tablet prenatal multivitamin , containing either low or high iron content . Methods Pregnant women who called the Motherisk Program ( Hospital for Sick Children , Toronto ) and had not started taking or had discontinued any multivitamin due to adverse events were included in this prospect i ve , r and omized , open-label , 2-arm study . Women were r and omized to take a small-size ( 16 mm × 9 mm × 4 mm ) , low elemental iron content ( 35 mg as ferrous fumarate ) multivitamin ( ' 35 mg ' group ) ; or a small-size ( 5 mm radius , 5 mm thickness ) , high elemental iron content ( 60 mg as ferrous sulphate ) multivitamin ( ' 60 mg ' group ) . Follow-up interviews documented pill intake and adverse events . Rates of adherence and adverse events were compared between groups using chi-squared tests and Kaplan-Meier survival curves . Results Of 167 r and omized women , 92 in the ' 35 mg ' group and 75 in the ' 60 mg ' group were included in the analysis . Despite ideal conditions and regular follow-ups , mean adherence based on pill intake recall , in both groups was approximately 50 % . No statistically significant difference was detected in proportions of women who actually started taking either multivitamin . Among those who started , no difference was detected in rates of adherence or reported adverse events . Conclusion The present results suggest that iron content is not a major determinant of adherence to prenatal multivitamins . Combined with our previous study , tablet size may be the more definitive factor affecting adherence Two hundred Hausa primigravidae at Zaria were divided into five groups in a r and omized double-blind trial of antenatal oral antimalarial prophylaxis , and haematinic supplements . Group 1 received no active treatment . Groups 2 to 5 were given chloroquine 600 mg base once , followed by proguanil 100 mg per day . In addition , group 3 received iron 60 mg daily , group 4 folic acid 1 mg daily , and group 5 iron plus folic acid .  Forty-five percent were anaemic ( haemoglobin ( Hb ) less than 11.0 g dl-1 ) at first attendance before 24 weeks of gestation , and malaria parasitaemia ( predominantly Plasmodium falciparum ) was seen in 27 % , of whom 60 % were anaemic . The mean Hb fell during pregnancy in group 1 , and seven patients in this group had to be removed from the trial and treated for severe anaemia ( packed cell volume ( PCV ) less than 0.26 ) . Only five patients in the other groups developed severe anaemia ( P = 0.006 ) , two of whom had malaria following failure to take treatment . Patients in group 1 had the lowest mean Hb at 28 and 36 weeks of gestation , and patients receiving antimalarials and iron ( groups 3 and 5 ) had the highest Hb at 28 weeks , but differences were not significant , possibly due to removal from the trial of patients with severe anaemia . Anaemia ( Hb less than 12.0 g dl-1 ) at six weeks after delivery was observed in 61 % of those not receiving active treatment ( group 1 ) , in 39 % of those protected against malaria but not receiving iron supplements ( groups 2 and 4 ) and in only 18 % of patients receiving both antimalarials and iron ( groups 3 and 5 ) . Folic acid had no significant effect on mean Hb .  Proguanil was confirmed to be a highly effective causal prophylaxis . Prevention of malaria , without folic acid supplements , reduced the frequency of megaloblastic erythropoiesis from 56 % to 25 % . Folic acid supplements abolished megaloblastosis , except in three patients who were apparently not taking the treatment prescribed . Red cell folate ( RCF ) concentrations were higher in subjects with malaria , probably due to intracellular synthesis by plasmodia . Infants of mothers not receiving antimalarials appeared to have an erythroid hyperplasia . Maternal folate supplements raised infants ' serum folate and RCF .  Fourteen per cent had low birth weight ( less than 2500 g ) , and the perinatal death rate was 11 % ; the greatest number were in group 1 , but not significantly . A regime is proposed for the prevention of malaria , iron deficiency , folate deficiency and anaemia in pregnancy in the guinea savanna of Nigeria Background Prenatal micronutrient combinations with high iron content are associated with high rates of gastrointestinal symptoms . This coupled with nausea and vomiting of pregnancy results in women often discontinuing their multivitamins . A new prescription supplement ( PregVit ® ) that separates iron from calcium in two tablets – morning and evening , has lower elemental iron content ( 35 mg ) , but results in similar extent of iron absorption when compared to another supplement containing ( 60 mg ) of elemental iron ( Materna ® ) . The objectives of this study were to compare tolerability and compliance with PregVit ® vs. a supplement with high iron content ( Materna ® ) , in pregnant women . Methods R and omized , crossover open labeled study in 135 pregnant women attending outpatient clinics in Ontario and Quebec . Results Use of PregVit ® was associated with a 30 % reduction in constipation rate as compared to Materna ® . Both products demonstrated similar compliance rates . Compliance of Materna ® was negatively associated with the severity of nausea and vomiting of pregnancy . No such correlation was found for PregVvit ® . Conclusion PregVit ® , a supplement with lower iron content ( 35 mg ) , has significantly decreased constipation rates as compared to 60 mg iron- Materna and has similar compliance rates . High iron content in multivitamin supplements is associated with adverse effects in pregnancy Background The purpose of this study was compare of daily iron supplementation in three time frames- daily , weekly and three time weekly supplementation in preventing anemia in healthy pregnant women . Method The present study was a prospect i ve simply r and omized clinical trial . During January 2006- January 2008 , 150 healthy pregnant women without anemia , in their 16th week of pregnancy were r and omly allocated into three equal groups . The first group ( n = 50 ) received a 50 mg-ferrous sulfate tablet daily , second group ( n = 50 ) received a 50 mg-ferrous sulfate tablet three times a week , and the third group ( n = 50 ) received two 50 mg-ferrous sulfate tablets ( 100 mg ) weekly , respectively for 12 consecutive weeks . Serum hemoglobin , ferritin , and iron were measured before and after the supplementation . Paired t and ANOVA tests were used as appropriated . Results There were no significant differences between the pre- and post-treatment hemoglobin levels with iron supplementation in the three group ( P = 0.518 , P = 0.276 , respectively ) . The mean serum iron level before and after treatment with iron supplementation in the three groups was not statistically significant ( P = 0.962 , P = 0.970 , respectively ) . Although the mean serum ferritin level before and after treatment with iron supplementation was statistically significant in the three groups , no significant differences were found comparing the three groups ( P = 0.827 , P = 0.635 respectively ) . Conclusions This results suggested , three times a week or weekly iron supplementation is as effective as daily supplementation for healthy pregnant women without anemia . Trial Registration IS RCT N : I RCT OBJECTIVE To evaluate whether levels of iron status markers ( haemoglobin , serum transferrin saturation , serum ferritin ) in pregnant women , measured in the beginning of the second trimester , could be used to predict levels later in pregnancy , pre partum and post partum . DESIGN R and omized , double-blind , placebo-controlled parallel study . SETTING The Birth Clinic at the Department of Obstetrics , Herning Hospital , Herning , Denmark . SUBJECTS One hundred and twenty healthy pregnant women between 14 and 18 weeks of gestation . INTERVENTIONS Sixty-three women were allocated to treatment with tablets containing 66 mg ferrous iron ( as fumarate ) daily , and 57 women to treatment with placebo . MAIN OUTCOME MEASURES Haemoglobin , serum transferrin saturation , and serum ferritin were measured every 4th week during gestation , prior to delivery , and 1 and 8 weeks post partum . RESULTS Correlation matrices during pregnancy and post partum were calculated for each iron status marker separately in iron-treated and placebo-treated women . Haemoglobin , transferrin saturation and serum ferritin values at inclusion displayed steadily declining correlation coefficients with values obtained later in pregnancy . There were no clinical ly relevant correlations to values obtained 8 weeks or less prior to delivery , and no correlations to values post partum . Serum ferritin values at inclusion could not be used to predict values later in pregnancy or post partum . CONCLUSION Haemoglobin , transferrin saturation and serum ferritin values measured in the beginning of the second trimester appear to be unsuitable as guidelines for an individual iron prophylaxis in pregnant women Bertino , J. R. , Ward , J. , Sartorelli , A. C. , and Silber , R. ( 1965 ) . 7 . clin . Invest . , 44 , 1028 . Bothwell , T. H. , Hurtardo , A. V. , Donohue , D. M. , and Finch , C. A. ( 1957 ) . Blood , 12 , 409 . Callender , S. T. , and Malpas , J. S. ( 1963 ) . Brit . med . 7 . , 2 , 1516 . Cockburn , F. , Sherman , J. D. , Ingall , D. , and Klein , R. ( 1965 ) . Proc . Soc . exp . Biol . ( N.Y. ) , 118 , 238 . Conrad , M. E. , Berman , A. , and Crosby , W. H. ( 1962 ) . Gastroenterology , 43 , 385 . Dacie , J. V. , and Lewis , S. M. ( 1963 ) . Practical Haematology , 3rd ed . London . Davis , A. E. , and Badenoch , J. ( 1962 ) . Lancet , 2 , 6 . Finch , C. A. , Coleman , D. H. , Motulsky , A. G. , Donohue , D. M. , and Reiff , R. H. ( 1956 ) . Blood , 11 , 807 . Herbert , V. ( 1963 ) . Amer . 7 . clan . Nutr . , 12 , 17 . Gottlieb , C. W. , and Altschule , M. D. ( 1965 ) . Lancet , 2 , 1052 Background Deficiencies of iron and folic acid during pregnancy can lead to adverse outcomes for the fetus , thus supplements are recommended . Adherence to current tablet-based supplements is documented to be poor . Recently a powdered form of micronutrients has been developed which may decrease side-effects and thus improve adherence . However , before testing the efficacy of the supplement as an alternate choice for supplementation during pregnancy , the bioavailability of the iron needs to be determined . Our objective was to measure the relative bioavailability of iron and folic acid from a powdered supplement that can be sprinkled on semi-solid foods or beverages versus a traditional tablet supplement in pregnant women . Methods Eighteen healthy pregnant women ( 24 – 32 weeks gestation ) were r and omized to receive the supplements in a crossover design . Following ingestion of each supplement , the changes 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Previous studies have found that there is a correlation between mothers ' haemoglobin concentration or packed cell volume and infants ' birth weight , and that iron supplementation increases mothers ' haemoglobin concentration . The purpose of this study , using the data of a large r and omised trial on iron prophylaxis during pregnancy , was to find out whether iron supplementation causes fetal growth to deteriorate . At their first antenatal visit , 2912 pregnant women were r and omised into non-routine iron and routine iron supplementation . The mean length of gestation was shorter in the non-routine group . Birth weight did not differ between the groups , but due to longer gestations boys in the group receiving routine iron were taller than in the non-routine group . In both groups , whether studied by various values of packed cell volume or correlation coefficients , the lower the packed cell volume , the heavier and taller the infant and heavier the placenta . These negative correlations could be seen even with a packed cell volume measured early in pregnancy . St and ardising for blood pressure did not influence the correlation coefficients . The correlation between a high ratio for packed cell volume and poor fetal growth thus may not be caused by iron supplementation , nor mediated by blood pressure , but by some other mechanism Background Gastrointestinal irritability can deter pregnant women from starting or continuing prenatal multivitamin supplementation . In a previous study , suboptimal tolerability was observed among pregnant women taking a large tablet ( 18 mm × 8 mm × 8 mm ) multivitamin with high elemental iron content ( 60 mg as ferrous fumarate ) . The objective of the present study was to compare rates of adherence and reported adverse events among pregnant women who were r and omized to commence supplementation with a small-tablet prenatal multivitamin , containing either low or high iron content . Methods Pregnant women who called the Motherisk Program ( Hospital for Sick Children , Toronto ) and had not started taking or had discontinued any multivitamin due to adverse events were included in this prospect i ve , r and omized , open-label , 2-arm study . Women were r and omized to take a small-size ( 16 mm × 9 mm × 4 mm ) , low elemental iron content ( 35 mg as ferrous fumarate ) multivitamin ( ' 35 mg ' group ) ; or a small-size ( 5 mm radius , 5 mm thickness ) , high elemental iron content ( 60 mg as ferrous sulphate ) multivitamin ( ' 60 mg ' group ) . Follow-up interviews documented pill intake and adverse events . Rates of adherence and adverse events were compared between groups using chi-squared tests and Kaplan-Meier survival curves . Results Of 167 r and omized women , 92 in the ' 35 mg ' group and 75 in the ' 60 mg ' group were included in the analysis . Despite ideal conditions and regular follow-ups , mean adherence based on pill intake recall , in both groups was approximately 50 % . No statistically significant difference was detected in proportions of women who actually started taking either multivitamin . Among those who started , no difference was detected in rates of adherence or reported adverse events . Conclusion The present results suggest that iron content is not a major determinant of adherence to prenatal multivitamins . Combined with our previous study , tablet size may be the more definitive factor affecting adherence Two hundred Hausa primigravidae at Zaria were divided into five groups in a r and omized double-blind trial of antenatal oral antimalarial prophylaxis , and haematinic supplements . Group 1 received no active treatment . Groups 2 to 5 were given chloroquine 600 mg base once , followed by proguanil 100 mg per day . In addition , group 3 received iron 60 mg daily , group 4 folic acid 1 mg daily , and group 5 iron plus folic acid .  Forty-five percent were anaemic ( haemoglobin ( Hb ) less than 11.0 g dl-1 ) at first attendance before 24 weeks of gestation , and malaria parasitaemia ( predominantly Plasmodium falciparum ) was seen in 27 % , of whom 60 % were anaemic . The mean Hb fell during pregnancy in group 1 , and seven patients in this group had to be removed from the trial and treated for severe anaemia ( packed cell volume ( PCV ) less than 0.26 ) . Only five patients in the other groups developed severe anaemia ( P = 0.006 ) , two of whom had malaria following failure to take treatment . Patients in group 1 had the lowest mean Hb at 28 and 36 weeks of gestation , and patients receiving antimalarials and iron ( groups 3 and 5 ) had the highest Hb at 28 weeks , but differences were not significant , possibly due to removal from the trial of patients with severe anaemia . Anaemia ( Hb less than 12.0 g dl-1 ) at six weeks after delivery was observed in 61 % of those not receiving active treatment ( group 1 ) , in 39 % of those protected against malaria but not receiving iron supplements ( groups 2 and 4 ) and in only 18 % of patients receiving both antimalarials and iron ( groups 3 and 5 ) . Folic acid had no significant effect on mean Hb .  Proguanil was confirmed to be a highly effective causal prophylaxis . Prevention of malaria , without folic acid supplements , reduced the frequency of megaloblastic erythropoiesis from 56 % to 25 % . Folic acid supplements abolished megaloblastosis , except in three patients who were apparently not taking the treatment prescribed . Red cell folate ( RCF ) concentrations were higher in subjects with malaria , probably due to intracellular synthesis by plasmodia . Infants of mothers not receiving antimalarials appeared to have an erythroid hyperplasia . Maternal folate supplements raised infants ' serum folate and RCF .  Fourteen per cent had low birth weight ( less than 2500 g ) , and the perinatal death rate was 11 % ; the greatest number were in group 1 , but not significantly . A regime is proposed for the prevention of malaria , iron deficiency , folate deficiency and anaemia in pregnancy in the guinea savanna of Nigeria Background Prenatal micronutrient combinations with high iron content are associated with high rates of gastrointestinal symptoms . This coupled with nausea and vomiting of pregnancy results in women often discontinuing their multivitamins . A new prescription supplement ( PregVit ® ) that separates iron from calcium in two tablets – morning and evening , has lower elemental iron content ( 35 mg ) , but results in similar extent of iron absorption when compared to another supplement containing ( 60 mg ) of elemental iron ( Materna ® ) . The objectives of this study were to compare tolerability and compliance with PregVit ® vs. a supplement with high iron content ( Materna ® ) , in pregnant women . Methods R and omized , crossover open labeled study in 135 pregnant women attending outpatient clinics in Ontario and Quebec . Results Use of PregVit ® was associated with a 30 % reduction in constipation rate as compared to Materna ® . Both products demonstrated similar compliance rates . Compliance of Materna ® was negatively associated with the severity of nausea and vomiting of pregnancy . No such correlation was found for PregVvit ® . Conclusion PregVit ® , a supplement with lower iron content ( 35 mg ) , has significantly decreased constipation rates as compared to 60 mg iron- Materna and has similar compliance rates . High iron content in multivitamin supplements is associated with adverse effects in pregnancy Background The purpose of this study was compare of daily iron supplementation in three time frames- daily , weekly and three time weekly supplementation in preventing anemia in healthy pregnant women . Method The present study was a prospect i ve simply r and omized clinical trial . During January 2006- January 2008 , 150 healthy pregnant women without anemia , in their 16th week of pregnancy were r and omly allocated into three equal groups . The first group ( n = 50 ) received a 50 mg-ferrous sulfate tablet daily , second group ( n = 50 ) received a 50 mg-ferrous sulfate tablet three times a week , and the third group ( n = 50 ) received two 50 mg-ferrous sulfate tablets ( 100 mg ) weekly , respectively for 12 consecutive weeks . Serum hemoglobin , ferritin , and iron were measured before and after the supplementation . Paired t and ANOVA tests were used as appropriated . Results There were no significant differences between the pre- and post-treatment hemoglobin levels with iron supplementation in the three group ( P = 0.518 , P = 0.276 , respectively ) . The mean serum iron level before and after treatment with iron supplementation in the three groups was not statistically significant ( P = 0.962 , P = 0.970 , respectively ) . Although the mean serum ferritin level before and after treatment with iron supplementation was statistically significant in the three groups , no significant differences were found comparing the three groups ( P = 0.827 , P = 0.635 respectively ) . Conclusions This results suggested , three times a week or weekly iron supplementation is as effective as daily supplementation for healthy pregnant women without anemia . Trial Registration IS RCT N : I RCT OBJECTIVE To evaluate whether levels of iron status markers ( haemoglobin , serum transferrin saturation , serum ferritin ) in pregnant women , measured in the beginning of the second trimester , could be used to predict levels later in pregnancy , pre partum and post partum . DESIGN R and omized , double-blind , placebo-controlled parallel study . SETTING The Birth Clinic at the Department of Obstetrics , Herning Hospital , Herning , Denmark . SUBJECTS One hundred and twenty healthy pregnant women between 14 and 18 weeks of gestation . INTERVENTIONS Sixty-three women were allocated to treatment with tablets containing 66 mg ferrous iron ( as fumarate ) daily , and 57 women to treatment with placebo . MAIN OUTCOME MEASURES Haemoglobin , serum transferrin saturation , and serum ferritin were measured every 4th week during gestation , prior to delivery , and 1 and 8 weeks post partum . RESULTS Correlation matrices during pregnancy and post partum were calculated for each iron status marker separately in iron-treated and placebo-treated women . Haemoglobin , transferrin saturation and serum ferritin values at inclusion displayed steadily declining correlation coefficients with values obtained later in pregnancy . There were no clinical ly relevant correlations to values obtained 8 weeks or less prior to delivery , and no correlations to values post partum . Serum ferritin values at inclusion could not be used to predict values later in pregnancy or post partum . CONCLUSION Haemoglobin , transferrin saturation and serum ferritin values measured in the beginning of the second trimester appear to be unsuitable as guidelines for an individual iron prophylaxis in pregnant women Bertino , J. R. , Ward , J. , Sartorelli , A. C. , and Silber , R. ( 1965 ) . 7 . clin . Invest . , 44 , 1028 . Bothwell , T. H. , Hurtardo , A. V. , Donohue , D. M. , and Finch , C. A. ( 1957 ) . Blood , 12 , 409 . Callender , S. T. , and Malpas , J. S. ( 1963 ) . Brit . med . 7 . , 2 , 1516 . Cockburn , F. , Sherman , J. D. , Ingall , D. , and Klein , R. ( 1965 ) . Proc . Soc . exp . Biol . ( N.Y. ) , 118 , 238 . Conrad , M. E. , Berman , A. , and Crosby , W. H. ( 1962 ) . Gastroenterology , 43 , 385 . Dacie , J. V. , and Lewis , S. M. ( 1963 ) . Practical Haematology , 3rd ed . London . Davis , A. E. , and Badenoch , J. ( 1962 ) . Lancet , 2 , 6 . Finch , C. A. , Coleman , D. H. , Motulsky , A. G. , Donohue , D. M. , and Reiff , R. H. ( 1956 ) . Blood , 11 , 807 . Herbert , V. ( 1963 ) . Amer . 7 . clan . Nutr . , 12 , 17 . Gottlieb , C. W. , and Altschule , M. D. ( 1965 ) . Lancet , 2 , 1052 Background Deficiencies of iron and folic acid during pregnancy can lead to adverse outcomes for the fetus , thus supplements are recommended . Adherence to current tablet-based supplements is documented to be poor . Recently a powdered form of micronutrients has been developed which may decrease side-effects and thus improve adherence . However , before testing the efficacy of the supplement as an alternate choice for supplementation during pregnancy , the bioavailability of the iron needs to be determined . Our objective was to measure the relative bioavailability of iron and folic acid from a powdered supplement that can be sprinkled on semi-solid foods or beverages versus a traditional tablet supplement in pregnant women . Methods Eighteen healthy pregnant women ( 24 – 32 weeks gestation ) were r and omized to receive the supplements in a crossover design . Following ingestion of each supplement , the changes 
    Output:
    