Body iron and individual iron prophylaxis in pregnancy—should the iron dose be adjusted according to serum ferritin?

  title={Body iron and individual iron prophylaxis in pregnancy—should the iron dose be adjusted according to serum ferritin?},
  author={Nils Thorm Milman and Keld-Erik Byg and Thomas Bergholt and Lisbeth Eriksen and Anne-Mette Hvas},
  journal={Annals of Hematology},
This study aims to evaluate iron prophylaxis in pregnant women from the individual aspect, i.e. according to serum ferritin levels at the beginning of pregnancy, and to assess which dose of iron would be adequate to prevent iron deficiency (ID) and iron deficiency anaemia (IDA) during pregnancy and postpartum. A randomised, double-blind study comprising 301 healthy Danish pregnant women allocated into four groups taking ferrous iron (as fumarate) in doses of 20 mg (n=74), 40 mg (n=76), 60 mg (n… 
Iron prophylaxis in pregnancy—general or individual and in which dose?
In the Western countries there is no consensus on iron prophylaxis to pregnant women, but suggested guidelines are ferritin >70 μg/l: no iron supplements, and individual iron proPHylaxis according to serumferritin concentration should be preferred to general prophYLaxis.
The Effectiveness of Different Doses of Iron Supplementation and the Prenatal Determinants of Maternal Iron Status in Pregnant Spanish Women: ECLIPSES Study
Iron supplementation should be adjusted to early pregnancy levels of Hb and iron stores, and Mutations of the HFE gene should be evaluated in women with high Hb levels in early pregnancy.
Serum ferritin, soluble transferrin receptor, and total body iron for the detection of iron deficiency in early pregnancy: a multiethnic population-based study with low use of iron supplements.
The prevalence of iron deficiency was significantly higher by all measures in South Asian, Sub-Saharan African, and Middle Eastern than in Western European women, and the ethnic differences persisted after adjusting for confounders.
Effect of different doses of iron supplementation during pregnancy on maternal and infant health
The higher the doses of iron supplementation, the lower the percentages of iron depletion at partum, iron deficiency anaemia, and preterm deliveries as well as a higher birth weight of the newborn.
Prevalence of iron deficiency states and risk of haemoconcentration during pregnancy according to initial iron stores and iron supplementation
The prevalence of ID and IDA was high in late pregnancy in healthy pregnant women, particularly in those with initial ID and/or those not taking supplements, and the risk of haemoconcentration was high at delivery, but did not seem to be promoted by Fe supplementation.
Iron status, and factors affecting iron status during the third trimester of pregnancy in Sudanese
Gravidity, gestational age, close birth spacing, and lack of iron supplementation are risk factors for iron deficiency during pregnancy.
Prepartum anaemia: prevention and treatment
Profound IDA has serious consequences for both woman and foetus and requires prompt intervention with intravenous iron, and is efficiently prevented by oral iron supplements in doses of 30–40 mg ferrous iron taken between meals from early pregnancy to delivery.
Intravenous iron isomaltoside versus oral iron supplementation for treatment of iron deficiency in pregnancy: protocol for a randomised, comparative, open-label trial
This randomised comparative, open-label, single-centre, phase IV trial is designed to prevent iron deficiency anaemia defined by a low level of haemoglobin throughout the trial, which can be used to consider the optimal 2nd line of treatment in iron-deficient pregnant women.


Iron supplementation during pregnancy. Effect on iron status markers, serum erythropoietin and human placental lactogen. A placebo controlled study in 207 Danish women.
The effect of iron supplementation, 66 mg elemental iron daily, from the 16th week of gestation to delivery, on iron status markers during uncomplicated pregnancies was assessed in a randomised,
Serum ferritin in Danes: studies of iron status from infancy to old age, during blood donation and pregnancy.
  • N. Milman
  • Medicine
    International journal of hematology
  • 1996
Iron and pregnancy—a delicate balance
In placebo-controlled studies on healthy pregnant women, there is no relationship between the women’s haemoglobin and birth weight of the newborns and no increased frequency of preeclampsia in women taking iron supplements.
Effect of iron supplementation on serum ferritin levels during and after pregnancy
Routine oral iron administration should be recommended during pregnancy, certainly after 28 weeks gestation, and at 6 months postpartum, individual and average serum and total plasma ferritin values showed a deficit compared with the values recorded at the beginning of pregnancy.
Serum transferrin receptor: a specific marker of iron deficiency in pregnancy.
BACKGROUND Current markers of iron deficiency tend to be less reliable in pregnancy. OBJECTIVE Our aim was to study the usefulness of soluble serum transferrin receptor (sTfR) as a marker for iron
Efficacy and tolerability of low-dose iron supplements during pregnancy: a randomized controlled trial.
BACKGROUND Iron deficiency anemia (IDA) is common in pregnant women, but previous trials aimed at preventing IDA used high-dose iron supplements that are known to cause gastrointestinal side effects.
Iron status in 268 Danish women aged 18–30 years: influence of menstruation, contraceptive method, and iron supplementation
It is demonstrated that even moderate daily doses of ferrous iron can influence iron status in women with small iron stores, suggesting that preventive measures should be focused on those women whose menstruation lasts 5 days or longer, who have menstrual bleeding of strong intensity, who use an IUD without gestagen, and who are blood donors.
Correlations Between Iron Status Markers During Normal Pregnancy in Women with and without Iron Supplementation.
The patterns of relationships in placebo-treated women were consistent with iron deficient erythropoiesis, and positive correlations appeared postpartum between ferritin, transferrin saturation and MCHC but not with haemoglobin.
Iron status in pregnant women: which measurements are valid?
The diagnostic accuracy of iron parameters including mean cellular volume, serum iron, transferrin, total iron binding capacity, and its saturation, zinc protoporphyrin, ferritin and serum transferrin receptor (TfR) for the assessment of iron status in a population of anaemic pregnant women in Malawi is examined.
Iron status and iron balance during pregnancy. A critical reappraisal of iron supplementation
In order to avoid iron deficiency in pregnancy, prophylactic iron supplement should be considered.