Iron Deficiency and Iron Deficiency Anemia: Implications and Impact in Pregnancy, Fetal Development, and Early Childhood Parameters

Abstract

A normal pregnancy consumes 500-800 mg of iron from the mother. Premenopausal women have a high incidence of marginal iron stores or iron deficiency (ID), with or without anemia, particularly in the less developed world. Although pregnancy is associated with a "physiologic" anemia largely related to maternal volume expansion; it is paradoxically associated with an increase in erythrocyte production and erythrocyte mass/kg. ID is a limiting factor for this erythrocyte mass expansion and can contribute to adverse pregnancy outcomes. This review summarizes erythrocyte and iron balance observed in pregnancy; its implications and impact on mother and child; and provides an overview of approaches to the recognition of ID in pregnancy and its management, including clinically relevant questions for further investigation.

Keywords: iron balance; iron deficiency; iron deficiency anemia; iron supplementation; laboratory testing; pregnancy.

Figure 1

Hemoglobin concentrations of healthy women during pregnancy (mean ± standard deviation. Data combined from references [19,20,21].

Figure 2

Peripheral blood film, iron deficiency anemia. (1000×, oil).