Feature Article

Iron deficiency in pregnancy: what you need to know

Giselle Kidson-Gerber, Silvia Zheng



Iron deficiency is common in pregnancy and has adverse effects for both the mother and child. It can and should be readily treated.

Key Points

  • Ideally, iron status should be checked and optimised before pregnancy.
  • Iron deficiency should be treated before anaemia develops: aim for a target ferritin level of 60 mcg/L.
  • Not all microcytic anaemias are due to iron deficiency. Haemoglobinopathy, which has potential consequences for both mother and child, needs to be excluded as a cause of iron deficiency.
  • Women should be educated about the side effects and interactions of oral iron replacement. This will increase the likelihood of them achieving adequate iron levels through oral replacement.
  • Intravenous iron preparations are currently safer and more convenient for treating pregnant women with iron deficiency. Iron repletion before delivery is preferable, with a lower threshold to prescribe intravenous iron such as iron carboxymaltose.

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