BackgroundIron deficiency but also iron overload during pregnancy has been associated with unwanted health effects. In Germany, iron supplements are only recommended for pregnant women with diagnosed iron deficiency/anaemia. Prevalence of anaemia among pregnant women was reported at 24.4% in 2011. However, limited data suggest that more than 60% of women in Germany use iron supplements during gestation. Against this background, we investigated the prevalence of iron supplement intake among pregnant women and explored determining factors in order to assess whether women are following the advice to only supplement iron in case of a diagnosed iron deficiency/anaemia.MethodsA cross-sectional study was carried out in four German states in 2015 where, with the help of midwives, women in childbed were asked to retrospectively answer a questionnaire about iron intake from various sources and reasons for supplementing iron during their recent pregnancy. We used Chi-square-tests and logistic regression analysis to evaluate associations between iron supplementation and other nutritional, sociodemographic and maternal variables and to assess attitudes of women meeting versus not meeting the official recommendation on iron supplement intake during pregnancy.ResultsOf 207 participants, 65.2% had supplemented iron. 84.4% reported to have done this because of a diagnosed iron deficiency/anaemia. Iron intake ranged from 5 to 200 mg/day, and duration of supplementation varied between two weeks and throughout gestation. Of women who reported to have been diagnosed with iron deficiency/anaemia, 47.5% had supplemented ≥80 mg/day iron, while 26.2% had taken iron in lower amounts ≤40 mg/day. Six percent of the participating women had not supplemented iron in spite of a diagnosed iron deficiency/anaemia, whereas 19.7% of women without iron deficiency/anaemia still had supplemented iron (range: 7 to 80 mg/day).ConclusionThe majority of pregnant women used iron supplements in case of a diagnosed iron deficiency/anaemia. However, not all women with iron deficiency/anaemia supplemented (sufficient amounts of) iron, while there was also indiscriminate use of iron supplements in women without iron deficiency/anaemia. Further research is warranted to confirm these findings in representative samples.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2130-5) contains supplementary material, which is available to authorized users.

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