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Review
. 2017 Dec 6;9(12):1327.
doi: 10.3390/nu9121327.

Iron Supplementation during Pregnancy and Infancy: Uncertainties and Implications for Research and Policy

Patsy M Brannon  1   2 , Christine L Taylor  3
Affiliations
Review

Iron Supplementation during Pregnancy and Infancy: Uncertainties and Implications for Research and Policy

Patsy M Brannon et al. Nutrients. .

Abstract

Iron is particularly important in pregnancy and infancy to meet the high demands for hematopoiesis, growth and development. Much attention has been given to conditions of iron deficiency (ID) and iron deficient anemia (IDA) because of the high global prevalence estimated in these vulnerable life stages. Emerging and preliminary evidence demonstrates, however, a U-shaped risk at both low and high iron status for birth and infant adverse health outcomes including growth, preterm birth, gestational diabetes, gastrointestinal health, and neurodegenerative diseases during aging. Such evidence raises questions about the effects of high iron intakes through supplementation or food fortification during pregnancy and infancy in iron-replete individuals. This review examines the emerging as well as the current understanding of iron needs and homeostasis during pregnancy and infancy, uncertainties in ascertaining iron status in these populations, and issues surrounding U-shaped risk curves in iron-replete pregnant women and infants. Implications for research and policy are discussed relative to screening and supplementation in these vulnerable populations, especially in developed countries in which the majority of these populations are likely iron-replete.

Keywords: infancy; iron supplementation; iron-replete; pregnancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Analytic framework for iron screening and supplementation of pregnant women and young children in developed countries. Solid lines highlight pathways supported by current evidence. Dashed lines highlight emerging evidence, uncertainties and research needs. Abbreviations include ID, iron deficiency; IDA, iron deficient anemia; GI, gastroinestine; GDM, gestational diabetes; T2D, type 2 diabetes. (From Brannon et al. [48] and reprinted with permission by American Journal of Clinical Nutrition: Am. J. Clin. Nutr. 2017; 106(Suppl): 1703S–12S. Printed in USA. © 2017 American Society for Nutrition).
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