Iron prophylaxis in pregnancy—general or individual and in which dose?
Open Access
- 9 June 2006
- journal article
- review article
- Published by Springer Science and Business Media LLC in Annals of Hematology
- Vol. 85 (12), 821-828
- https://doi.org/10.1007/s00277-006-0145-x
Abstract
Iron is mandatory for normal fetal development, including the brain. Iron deficiency may have deleterious effects for intelligence and behavioral development. It is important to prevent iron deficiency in the fetus by preventing iron deficiency in the pregnant woman. Iron deficiency anemia during pregnancy is a risk factor for preterm delivery and low birth weight. In the Western countries there is no consensus on iron prophylaxis to pregnant women. An adequate iron balance during pregnancy implies body iron reserves of ≥500 mg at conception. The physiologic iron requirements in the second half of gestation cannot be fulfilled solely through dietary iron. Iron supplements during gestation consistently increase serum ferritin and hemoglobin and reduce the prevalence of iron deficiency anemia. Iron has a negative influence on absorption of other divalent metals and increases oxidative stress in pregnancy, for which reason minimum effective iron dose should be advised. From a physiologic point of view, individual iron prophylaxis according to serum ferritin concentration should be preferred to general prophylaxis. Suggested guidelines are (1) ferritin >70 μg/l: no iron supplements; (2) ferritin 30–70 μg/l: 40 mg ferrous iron daily; and (3) ferritin <30 μg/l: 80–100 mg ferrous iron daily. In controlled studies, there are no documented side effects of iron supplements below 100 mg/day. Iron supplements should be taken at bedtime or between meals to ensure optimum absorption.Keywords
This publication has 53 references indexed in Scilit:
- Perinatal aspects of iron metabolismActa Paediatrica, 2002
- Iron status at 9 months of infants with low iron stores at birthThe Journal of Pediatrics, 2002
- Identification and Localization of Divalent Metal Transporter-1 (DMT-1) in Term Human PlacentaPlacenta, 2000
- Perinatal Iron Deficiency and the Developing BrainPediatric Research, 2000
- Anemia and iron deficiency: effects on pregnancy outcomeThe American Journal of Clinical Nutrition, 2000
- Effect of iron supplementation on the iron status of pregnant women: consequences for newbornsThe American Journal of Clinical Nutrition, 1997
- A longitudinal study of iron status in healthy Danish infants: effects of early iron status, growth velocity and dietary factorsActa Paediatrica, 1995
- Serum Ferritin and Iron Status in Mothers and Newborn InfantsActa Obstetricia et Gynecologica Scandinavica, 1987
- Iron requirement in normal pregnancy as assessed by serum ferritin, serum transferrin saturation and erythrocyte protoporphyrin determinationsBJOG: An International Journal of Obstetrics and Gynaecology, 1983
- Transferrin receptor affinity and iron transport in the human placentaPlacenta, 1981