Cited by 160Iron Metabolism and DisordersHemoglobinopathies and Related DisordersErythropoietin and Anemia Treatment

The incidence, complications, and treatment of iron deficiency in pregnancy

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Benson, Ashley E., Shatzel, Joseph J., Ryan, Kim S., Hedges, Madeline A., Martens, Kylee, Aslan, Joseph E., Lo, Jamie O.·2022·European Journal of Haematology

Abstract

Iron deficiency and/or iron deficiency anemia (IDA) complicate nearly 50% of pregnancies globally, negatively impacting both maternal and fetal outcomes. Iron deficiency can cause a range of symptoms that range from aggravating to debilitating including fatigue, poor quality of life, pagophagia, and restless leg syndrome. Iron deficiency and IDA are also associated with maternal complications including preterm labor, increased rates of cesarean delivery, postpartum hemorrhage, and maternal death. Fetal complications include increased rates of low birth weight and small for gestational age newborns. Prenatal maternal anemia has also been associated with autism spectrum disorders in the neonate, although causation is not established. Deficiency in the newborn is associated with compromised memory, processing, and bonding, with some of these deficits persisting into adulthood. Despite the prevalence and consequences associated with iron deficiency in pregnancy, data show that it is routinely undertreated. Due to the physiologic changes of pregnancy, all pregnant individuals should receive oral iron supplementation. However, the bioavailability of oral iron is poor and it is often ineffective at preventing and treating iron deficiency. Likewise, it frequently causes gastrointestinal symptoms that can worsen the quality of life in pregnancy. Intravenous iron formulations administered in a single or multiple dose series are now available. There is increasing data suggesting that newer intravenous formulations are safe and effective in the second and third trimesters and should be strongly considered in pregnant individuals without optimal response to oral iron repletion.

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  1. [24]Organization WH. Anaemia in Women and Children: WHO Global Anaemia Estimates, 2021 Edition. World Health Organization: Geneva, Switzerland. 2021.
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Authors
Benson, A. E., Shatzel, J. J., Ryan, K. S., Hedges, M. A., Martens, K., Aslan, J. E., & Lo, J. O.
Affiliations
  • Oregon Health & Science University (US)
  • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Oregon Health and Science University Portland Oregon USA
Corresponding author
Lo, Jamie O.
Venue
European Journal of Haematology
Publisher
Wiley
Published
2022-10-04
Volume
109
Issue
6
Pages
633-642
ISSN
  • 0902-4441 (ISSN-L)
  • 1600-0609
OpenAlex
W4297145701
Cited by
159
References
100
Citations by year
2026: 50 · 2025: 47 · 2024: 41 · 2023: 21
FWCI
4.86
Type
journal article
Language
en
Open access
Locations
  • European Journal Of Haematology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Heart, Lung, and Blood Institute
  • National Institutes of Health (P51‐OD‐011092)
Topics
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
  • Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
Keywords
iron deficiency in pregnancy, iron deficiency anemia, anemia in pregnancy, oral iron supplementation, intravenous iron, iron bioavailability, maternal complications, fetal complications, low birth weight, autism spectrum disorder, postpartum hemorrhage, preterm labor, cesarean section, restless legs syndrome, pagophagia
MeSH terms
Iron Deficiencies, Adult, Anemia, Female, Humans, Infant, Newborn, Iron, Pregnancy, Pregnancy Complications, Hematologic, Quality of Life, Incidence, Anemia, Iron-Deficiency

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