Prevalence, complications and treatment of iron deficiency in pregnancy

Iron deficiency anemia is the most common form of anemia in pregnancy, occurring in approximately 30-40% of cases. The causes of the occurrence and maintenance of iron deficiency in pregnancy are represented by the perpetuation of a pattern characterized by the occurrence of heavy menstrual bleeding during puberty, precarious and insufficient nutritional intake and, finally, the occurrence of pregnancy with increased iron requirements. The diagnosis of iron deficiency anemia is established based on the decrease in hemoglobin and ferritin levels, with a cut-off value established at 11 g/dL in the case of hemoglobin. Effects on the mother range from asthenia, difficulty concentrating to thyroid disorders or postpartum depression. Maternal-fetal consequences, such as postpartum hemorrhages, low birth weight and premature birth, are significantly reduced by adequate supplementation with iron preparations, orally or intravenously, during pregnancy. Thus, a correct and complete follow-up of the pregnant woman includes, according to the guidelines, the hemoglobin dosage when the patient is taken into account, with the repetition of its dosage at 28 weeks of pregnancy. In Romania, the guidelines recommend ferritin dosing in cases at risk of developing iron deficiency anemia (adolescent girls, twin pregnancies, pregnancies less than a year apart). The choice is oral supplementation in order to prevent the onset of anemia, with the mention of adverse effects of frequent gastrointestinal cause. There is the possibility of parenteral administration in case of severe iron deficiency anemia (Hb<7 g/dL) preoperatively or before the time of birth, or in case of intolerance to oral therapy. Despite all the measures implemented in recent years, the prevalence of anemia continues to be high, a fact that requires a better prevention and education campaigns, especially in countries with low socioeconomic status.