Iron status in pregnant women and women of reproductive age in Europe
Open accessAbstract
Understanding the iron status in pregnant women in Europe provides a foundation for considering the role of iron screening and supplementation. However, available reports and studies have used different approaches that challenge the devising of overall summaries. Moreover, data on pregnant women are limited, and thus, data on women of reproductive age provide useful background information including baseline iron stores in pregnant women. This review considered data that are available from >15 European countries including national surveys and relevant clinical studies. In European women of reproductive age, median or geometric mean serum ferritin (SF) concentrations were estimated at 26-38 μg/L. Approximately 40-55% of this population had small or depleted iron stores (i.e., SF concentration ≤30 μg/L), and 45-60% of this population had apparently replete iron stores. The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) was 10-32% and 2-5%, respectively, depending on the cutoffs used. Approximately 20-35% of European women of reproductive age had sufficient iron stores (SF concentration >70 μg/L) to complete a pregnancy without supplementary iron. During pregnancy, European women in controlled supplementation trials who were not receiving iron supplements displayed increasing prevalences of ID and IDA during pregnancy, which peaked in the middle to late third trimester. Available evidence has suggested that, in gestational weeks 32-39, the median or geometric mean SF concentrations were 6-21 μg/L, and prevalences of ID and IDA were 28-85% and 21-35%, respectively. Women who were taking iron supplements had higher iron status and lower prevalences of ID and IDA, which were dependent on the dose of iron and compliance. The data suggest that, in Europe, the iron status of reproductive-aged women varies by region and worsens in pregnancy without iron supplementation.
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Among those women, the prevalence of NAID was 10-32% and of IDA was 2-5%, depending on the cutoffs used.
“The prevalence of NAID and IDA were 10–32% and 2–5%, depending on the cutoffs used.”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [27]
The Conclusions report IDA prevalence of 2–5% and ID prevalence of 10–33% among predominantly Western European women of reproductive age. The cited 10–32% range is close to the reported ID range, and the paper discusses differing ferritin cutoffs, but it reports ID rather than non-anemic iron deficiency (NAID). ID cannot be treated as NAID without excluding women with IDA. (LLM, conf=0.88)
Experimental — accuracy not yet measuredApproximately 40-55% of women of reproductive age from more than 15 European countries had iron deficiency (SF ≤30 ng/mL).
“Approximately 40–55% of this population had ID (i.e., an SF concentration ≤30 ng/mL).”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [27]
The section on apparently healthy women of reproductive age reports that about 40–50% had small or depleted iron stores at the stated ferritin cutoff. It explicitly distinguishes that group from women with iron deficiency; the Conclusions give iron-deficiency prevalence as 10–33%, not 40–55%. (LLM, conf=0.89)
Experimental — accuracy not yet measuredAbout 20-35% of European women of reproductive age had enough iron stores (SF >70 ng/mL) to complete a pregnancy without supplementary iron.
“About 20–35% of European women in their reproductive ages had enough iron stores (SF concentration >70 ng/mL) to complete a pregnancy without supplementary iron [27].”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [27]
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- Authors
- Milman, N., Taylor, C. L., Merkel, J., & Brannon, P. M.
- Affiliations
- Næstved Sygehus (DK)
- National Institutes of Health (US)
- Corresponding author
- Milman, Nils
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 106
- Issue
- Suppl 6
- Pages
- 1655S-1662S
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC5701710
- OpenAlex
- W2767104704
- Cited by
- 225
- References
- 53
- Citations by year
- 2026: 9 · 2025: 24 · 2024: 27 · 2023: 33 · 2022: 58 · 2021: 25 · 2020: 24 · 2019: 14 · 2018: 7 · 2017: 2
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Keywords
- iron status, pregnant women, women of reproductive age, serum ferritin, iron deficiency, iron deficiency anemia, iron supplementation, iron stores, European women
- MeSH terms
- Iron Deficiencies, Europe, Female, Ferritins, Hemoglobins, Humans, Iron, Pregnancy, Anemia, Iron-Deficiency, Dietary Supplements
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