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Review
. 1999 Oct;78(9):749-57.

Iron status and iron balance during pregnancy. A critical reappraisal of iron supplementation

N Milman  1 , T Bergholt, K E Byg, L Eriksen, N Graudal
Affiliations
  • PMID: 10535335
Review

Iron status and iron balance during pregnancy. A critical reappraisal of iron supplementation

N Milman et al. Acta Obstet Gynecol Scand. 1999 Oct.

Abstract

Background: Iron supplementation in pregnancy is a controversial issue. The aim of this review was to summarize the results of relevant papers on this subject.

Methods: Placebo-controlled studies on iron treatment in pregnancy were identified from the Cochrane database.

Results: Among fertile women, 20% have iron reserves of >500 mg, which is the required minimum during pregnancy; 40% have iron stores of 100-500 mg, and 40% have virtually no iron stores. The demand for absorbed iron increases from 0.8 mg/day in early pregnancy to 7.5 mg/day in late pregnancy. Dietary iron intake in fertile women is median 9 mg/day, i.e. the majority of women have an intake below the estimated allowance of 12 18 mg/day. Iron absorption increases in pregnancy, but not enough to prevent iron deficiency anemia in 20%, of women not taking supplementary iron. Iron-treated pregnant women have greater iron reserves, higher hemoglobin levels, and a lower prevalence of iron deficiency anemia than placebo-treated women both in pregnancy as well as postpartum. Furthermore, children born to iron-treated mothers have higher serum ferritin levels than those born to placebo-treated mothers. An iron supplement of 65 mg/day from 20 weeks of gestation is adequate to prevent iron deficiency anemia.

Conclusions: In order to avoid iron deficiency in pregnancy, prophylactic iron supplement should be considered. Iron supplements may be administered on a general or selective basis. The selective approach implies screening with serum ferritin in early pregnancy, in order to identify women who can manage without prophylactic iron.

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Comment in

  • Use of supplement iron in pregnancy.
    Hemminki E. Hemminki E. Acta Obstet Gynecol Scand. 2000 Jul;79(7):620-1. doi: 10.1034/j.1600-0412.2000.079007620.x. Acta Obstet Gynecol Scand. 2000. PMID: 10929970 No abstract available.

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