ACOG Practice Bulletin no. Anemia in pregnancy. Article type [CB]. Practice Guidelines. Citation [CB]. Obstet Gynecol ; Appropriate evaluation and treatment of anemia in pregnancy; Iron of Obstetricians and Gynecologists (ACOG); Jul. 7 p. (ACOG practice bulletin; no. 95). Anemia, the most common hematologic abnormality, is a reduction in the concentration of erythrocytes or hemoglobin in blood. The two most common causes of.

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Both the and the current recommendation statements found insufficient evidence to determine the balance of the benefits and harms of iron supplementation during pregnancy Department of Health and Human Services. Iron is necessary for the production of hemoglobin, which is an essential protein found in erythrocytes. You will be directed to acponline. Siu AL, on behalf of the U. Further, of 4 studies 15, 20—22 reporting on small-for-gestational-age infants, 1 study 22 reported no significant difference in rates between supplemented and nonsupplemented groups, 2 studies 15, 21 reported fewer small-for-gestational-age infants in supplemented groups, and 1 study 20 prengancy more small-for-gestational-age infants in the supplemented group.

The following recommendations buletin conclusions are based on limited or inconsistent evidence Level B:. According to acpg Institute of Medicine, the Recommended Dietary Allowance for iron in pregnant women is 27 mg per day.

A few comments requested more information on which populations are at increased risk for iron deficiency anemia and to which population the recommendation applies. Topics Discussed in This Paper.

A randomized, placebo controlled trial of low dose iron supplementation with and without heme iron. Preconceptional and prenatal multivitamin-mineral supplement use in the National Maternal and Infant Health Survey. The information annemia verified by the guideline developer on January 23, Anemia American College of Obstetricians and Gynecologists.

Several studies reported inconsistent findings on these health outcomes. Preventive Services Task Force:.

ACOG Practice Bulletin No. anemia in pregnancy. Obstet Gynecol. (1):

Hassana SalifuNana O. The harms of screening for iron deficiency anemia have not been well-studied but are likely minor. Reported benefits of supplementation were limited to intermediate anenia maternal hematologic indexesand evidence on the benefits of supplementation on maternal and infant health outcomes was inadequate because of inconsistent results and underpowered studies.


The following conclusion is based on good and consistent scientific evidence Level A: Proposed performance measures are included in the original guideline document. It does not address pregnant women who are malnourished, have symptoms of iron deficiency anemia, or have special hematologic conditions or nutritional needs that may increase their need for iron.

Levels of Recommendations Level A – Recommendations are based on good and consistent scientific evidence.

ACOG Practice Bulletin No. 95: anemia in pregnancy.

Although adequate evidence shows that supplementation increases hemoglobin and ferritin levels, the evidence is unclear on whether this increase leads to an improvement in maternal and fetal health outcomes.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency anemia in pregnant women to prevent adverse maternal health and birth outcomes.

Effectiveness of screening for anemia during pregnancy Effectiveness of anemia prophylaxis during pregnancy.

Intravenous iron treatment is also used during pregnancy. The mothers were followed till delivery.

Anemia in pregnancy.

This is the current release of the guideline. Studies used varying doses of iron, ranging from 20 to mg per day. Rates may be higher in low-income and minority populations 1, 2. The NCBI database was searched from to Potential Benefits Appropriate evaluation and treatment of anemia in pregnancy Iron supplementation decreases the prevalence of maternal anemia at delivery Potential Harms There is little evidence that iron supplementation results in morbidity beyond gastrointestinal symptoms, except in patients with hemochromatosis or certain other genetic disorders.

Goudar Reproductive health Non-Hispanic black and Mexican American women have higher prevalence rates of iron deficiency than white women and women with parity of 2 or more. The USPSTF focused on reviewing the evidence on the association between change in iron status as a result of intervention oral supplementation or treatment in pregnant women and adolescents and improvement in maternal and infant health outcomes.

No good- or fair-quality studies were found that evaluated the benefits or harms of screening in this population. Most reported harms, including nausea, constipation, and diarrhea, were transient and not serious.


In general, no significant difference was found between supplemented and control groups. Hemoglobin screening in second trimester is necessary for pregnant women along with correcting the anemia from the second trimester to improve the maternal outcome. Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes: Iron requirement in normal pregnancy as assessed by serum ferritin, serum transferrin saturation and erythrocyte protoporphyrin determinations.

Iron supplementation Screening for anemia during pregnancy Maternal transfusion in case of severe anemia Parenteral iron for patients who cannot tolerate oral iron: Buy This Article Subscribe.

ACOG Practice Bulletin No. anemia in pregnancy.

Routine iron supplementation and screening for iron deficiency anemia in pregnancy: The two most common causes of anemia qnemia pregnancy and bulleitn puerperium are iron deficiency and acute blood loss. Higher doses 60 to mg of elemental iron per day are sometimes prescribed in populations at increased risk for iron deficiency anemia 2. However, given the hemodilution and physiologic anemia that normally occurs during pregnancy, using hemoglobin or hematocrit measurement alone to determine iron deficiency status can be imprecise, and its sensitivity and specificity for detecting iron deficiency anemia in pregnant women are unknown.

MastiholiManjunath S. This paper has been referenced on Twitter 1 time over the past 90 days. IV iron does not increase serious adverse events compared with other forms of iron Annals of Internal Medicine; Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes.

Existing language describing risk factors for iron deficiency anemia and the target population for this recommendation was inserted earlier in the statement to make this information clearer.