SUMMARY: Anemia in pregnancy and low birth weight babies are a problem prevalent in India and other nations. This communication reports the results of a novel initiative to address the issue. The uniqueness of the strategy lies in the withdrawal of fluoride (F), consumed through a variety of sources including water. The study was conducted in two Delhi Government hospitals where 3,262 pregnant women visiting Antenatal Clinics (ANCs) were screened. The women selected were up to 20 weeks pregnant with a low hemoglobin (Hb) of 5.0–11.0 g/dL, a urine F level (UFL) of>1.0 mg/L, and not suffering from any other ailments. A total of 481 pregnant women were grouped, through a computerized random sampling procedure, into sample (n=234) and control (n=247) groups. The sample group were introduced to two interventions: (1) removal of F from their diet (2) dietary counselling based on ensuring an adequate intake of essential nutrients through dairy products, vegetables, and fruits. No intervention was introduced to the control group. At their ANC visits, until delivery, both groups received a supply of iron and folic acid (100 mg iron + 500 g folic acid) and had their UFL and Hb levels monitored. The Body Mass Index (BMI) was recorded at the initial contact and prior to delivery. The birth weight of the babies and other details were recorded from the labour room register. The results revealed that in the sample group women, the BMI increased, the UFL decreased in 65.0%(152/234), the Hb increased in 77.7% (182/234), the percentage of pre-term deliveries (<34 weeks) was 1%, the foetal wastage was0.4%, and the birth weight of the babies was normal (2.5 kg) in 82.5% (193/234) and low in 17.5% (41/234). In contrast, in the control group the UFL decreased in 49%, the Hb increased in 56.7%, pre-term deliveries were 5%, foetal wastage was 2.4%,and the birth weight was normal in 59% and low in 41%. The overall benefits accrued through the interventions were extraordinary and undoubtedly prove, for the first time, that anemia in pregnancy is mainly due to the non-absorption of nutrients, including iron and folic acid supplements, due to the adverse effects of F on the gastrointestinal mucosa. The withdrawal of F helped rectify the mucosal damage allowing the absorption of nutrients and the correction of the anemia.
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