Anaemia during Pregnancy - Review Part 2

Overview

Objective:
To review the clinical risks of iron deficiency anemia (IDA) in pregnant women: a list ofthe possible disorders of the mother, fetus and the newborn. A discussion about the clinical valueof iron administration in gestation.Design: Review article.Setting: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Facul-ty Hospital, Charles University, Prague. Apolinářská 18, Prague 2, 128 00.Methods: Analysis of the results in literature (texts in medical journals, monographies, textbooks,internet - „Medline“) and authors’ clinical experience.Conclusions: Routine iron supplementation in pregnancy is still a controversial issue. The keyquestion is, whether improving the mother’s laboratory parameters helps to improve her clinicalstatus and the clinical outcome of pregnancy.There is no doubt that iron supplementation in pregnancy decreases the incidence of anemia andincreases the level of iron stores in the 2nd and 3rd trimester of gestation as well as in thepuerperium. Even with the presence of many recent studies there still exists a lack of properevidence, that routine iron administration in pregnancy leads to improvement of the clinicalstatus of the mother and fetus. Up to this time there is not sufficient proof either in favour of oragainst iron supplementation in pregnancy.In conclusion, there is a need for further research (randomized, controlled, clinical trials focusedon the clinical outcomes of pregnancy, with a sufficient amount of pregnant women and withrepresentative statistical evaluation; or careful metaanalysis of the existing studies) to reachdefinite results about the importance of iron administration and about the treatment of asympto-matic anemia in gestation.

Key words:
iron deficiency anemia (IDA), clinical aspects of IDA in pregnancy, operative delivery,premature delivery, intrauterine growth retardation (IUGR), low birth weight (LBW), perinatalmorbidity and mortality, psychomotor development of the newborn