Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy: US Preventive Services Task Force Recommendation Statement

Published in JAMA. Here is a link to the article.

Regenstrief Institute authors: Sarah Wiehe, M.D., MPH

Abstract

Importance: Iron deficiency is the leading cause of anemia during pregnancy. According to survey data from 1999 to 2006, overall estimated prevalence of iron deficiency during pregnancy is near 18% and increases across the 3 trimesters of pregnancy (from 6.9% to 14.3% to 28.4%). An estimated 5% of pregnant persons have iron deficiency anemia.

Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on the benefits and harms of screening and supplementation for iron deficiency with and without anemia on maternal and infant health outcomes in asymptomatic pregnant persons.

Population: Asymptomatic pregnant adolescents and adults.

Evidence assessment: The USPSTF concludes that the current evidence is insufficient, and the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in asymptomatic pregnant persons on maternal and infant health outcomes cannot be determined. The USPSTF also concludes that the current evidence is insufficient, and the balance of benefits and harms of iron supplementation in asymptomatic pregnant persons on maternal and infant health outcomes cannot be determined.

Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine supplementation for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes. (I statement).

Authors: 

US Preventive Services Task Force; Wanda K Nicholson ¹, Michael Silverstein ², John B Wong ³, David Chelmow ⁴, Tumaini Rucker Coker ⁵, Esa M Davis ⁶, Carlos Roberto Jaén ⁷, Marie Krousel-Wood ⁸, Sei Lee ⁹, Li Li ¹⁰, Goutham Rao ¹¹, John M Ruiz ¹², James Stevermer ¹³, Joel Tsevat ⁷, Sandra Millon Underwood ¹⁴, Sarah Wiehe ¹⁵

Affiliations: 

¹George Washington University, Washington, DC.

²Brown University, Providence, Rhode Island.

³Tufts University School of Medicine, Boston, Massachusetts.

⁴Virginia Commonwealth University, Richmond.

⁵University of Washington, Seattle.

⁶University of Maryland School of Medicine, Baltimore.

⁷University of Texas Health Science Center, San Antonio.

⁸Tulane University, New Orleans, Louisiana.

⁹University of California, San Francisco.

¹⁰University of Virginia, Charlottesville.

¹¹Case Western Reserve University, Cleveland, Ohio.

¹²University of Arizona, Tucson.

¹³University of Missouri, Columbia.

¹⁴University of Wisconsin, Milwaukee.

¹⁵Indiana University, Bloomington.