Maternal iron status: relation to fetal growth, length of gestation, and iron endowment of the neonate

Abstract

Anemia prevalence is highest in preschool children, reproductive age women and women who are pregnant. While etiology is multifactorial, a deficiency in iron is the most commonly recognized nutritional cause. Observational studies imply that supplementation with iron or iron-folic acid should be started early in pregnancy, if not before, in order to prevent low birth weight and preterm delivery. Despite this clinical trials, even those from early pregnany, are equivocal. Recent follow up studies of children born to iron-folic acid supplemented women suggest that mortality is decreased and that the infant’s iron endowment reflects the mother’s iron status during pregnancy.

Prevalence and Risk Factors for Iron Deficiency Anemia and Iron Depletion During Pregnancy: A Prospective Study

“…20,21 Therefore, iron supplementation in pre-pregnancy and early in pregnancy may be considered, only for women with low serum ferritin concentration and anemia. 6,12,20 This study presents some limitations. It included only fifteen multiple pregnancies which is probably insufficient to provide reliable conclusions regarding this group.…”

“…Also, in the first trimester, it may be beneficial to evaluate the serum ferritin, to identify women with iron depletion and at risk of anemia. 6 A low SF may warrant an early intervention and iron status improvement with iron supplementation. The positive effects of adequate iron supplementation during pregnancy are well known and include improved birth weight and reduction in preterm labour and perinatal morbidity.…”

“…8 Furthermore, iron requirements increase for pregnant women and are difficult to achieve by diet alone. 1,3,6 Iron deficiency anemia has been linked to negative maternal-fetal outcomes. For mothers, these include reduced working and intellectual capacity, increased susceptibility to infection, higher risk of post-partum anemia and depression.…”

“…5 During pregnancy, anemia is defined as a hemoglobin (Hb) concentration < 11.0 g/dL in the first and third trimesters and Hb < 10.5 g/dL in the second trimester. 6 Multiple factors may lead to anemia during this period, namely nutritional deficiencies, hemolysis and abnormal hemoglobin synthesis, blood loss, defective iron absorption and metabolism, and chronic conditions. Iron-deficiency (ID) is the most common cause of anemia in pregnancy.…”

“…The spectrum of ID ranges from iron depletion, to deficient erythropoiesis and to iron deficient anemia. 6,8 The prevalence of ID can be 2 -2.5 times that of iron deficiency anemia (IDA). The risk factors related to IDA include teenage pregnancy, high parity, multiple pregnancies and reduced inter-pregnancy intervals.…”