Rapid Response

Iron Supplementation in Pregnancy: More Harm than Good?

Authors: Howard A. Shaw, MD, Julia A. Shaw, MD

Abstract

Iron Supplementation in Pregnancy: More Harm than Good?


Daily iron supplementation is extensively used as an intervention to prevent and correct iron deficiency anemia during pregnancy. The Institute of Medicine recommends a daily dietary allowance of 27 mg/day of ferrous iron for women during pregnancy.1 However, some authors have found a negative impact of this practice, particularly in pregnant women who are not anemic. These authors noted a 1.79-fold increased risk for small gestational age (SGA) infants in women with a hemoglobin above 14.4 g/dL during the third trimester.2

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References

1. Institute of Medicine. Iron. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press; 2001:290–393.
 
2. Lao TT, Tam KF, Chan LY. Third trimester iron status and pregnancy outcome in non-anaemic women; pregnancy unfavourably affected by maternal iron excess. Hum Reprod 2000;15:1843–1848.
 
3. Scanlon KS, Yip R, Schieve LA, et al. High and low hemoglobin levels during pregnancy: differential risk for preterm birth and small for gestational age. Obstet Gynecol 2000;96:741–748.
 
4. Ziaei S, Norrozi M, Faghihzadeh S, et al. A randomised placebo-controlled trial to determine the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin 13.2 g/dl. BJOG 2007;114:684–688.
 
5. Murphy JF, O'Riordan J, Newcombe RG, et al. Relation of hemoglobin levels in first and second trimesters to outcome of pregnancy. Lancet 1986;1:992–995.
 
6. Pena-Rosas JP, Viteri FE. Effects of routine oral iron supplementation with or without folic acid for women during pregnancy. Cochrane Database Syst Rev 2006;3:CD004736.