Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections

J Perinat Med. 2020 Dec 21;49(4):431-438. doi: 10.1515/jpm-2020-0379. Print 2021 May 26.

Abstract

Objectives: Gestational IDA has been linked to adverse maternal and neonatal outcomes, but the impact of iron supplementation on outcome measures remains unclear. Our objective was to assess the effects of gestational IDA on pregnancy outcomes and compare outcomes in pregnancies treated with either oral or intravenous iron supplementation.

Methods: We evaluated maternal and neonatal outcomes in 215 pregnancies complicated with gestational IDA (Hb<100 g/L) and delivered in our tertiary unit between January 2016 and October 2018. All pregnancies from the same period served as a reference group (n=11,545). 163 anemic mothers received oral iron supplementation, and 52 mothers received intravenous iron supplementation.

Results: Gestational IDA was associated with an increased risk of preterm birth (10.2% vs. 6.1%, p=0.009) and fetal growth restriction (FGR) (1.9% vs. 0.3%, p=0.006). The gestational IDA group that received intravenous iron supplementation had a greater increase in Hb levels compared to those who received oral medication (18.0 g/L vs. 10.0 g/L, p<0.001), but no statistically significant differences in maternal and neonatal outcomes were detected.

Conclusions: Compared to the reference group, prematurity, FGR, postpartum infections, and extended hospital stays were more common among mothers with gestational IDA, causing an additional burden on the families and the healthcare system.

Keywords: fetal growth restriction; gestational anemia; intravenous iron supplementation; iron deficiency anemia in pregnancy; postpartum complications; preterm birth.

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Adult
  • Anemia, Iron-Deficiency* / complications
  • Anemia, Iron-Deficiency* / diagnosis
  • Anemia, Iron-Deficiency* / therapy
  • Female
  • Fetal Growth Retardation* / diagnosis
  • Fetal Growth Retardation* / etiology
  • Fetal Growth Retardation* / prevention & control
  • Hemoglobins / analysis
  • Humans
  • Infant, Newborn
  • Iron / administration & dosage*
  • Outcome Assessment, Health Care
  • Pregnancy
  • Pregnancy Complications, Hematologic* / diagnosis
  • Pregnancy Complications, Hematologic* / therapy
  • Pregnancy Outcome / epidemiology
  • Premature Birth* / blood
  • Premature Birth* / etiology
  • Premature Birth* / prevention & control
  • Puerperal Infection* / diagnosis
  • Puerperal Infection* / etiology
  • Puerperal Infection* / prevention & control
  • Trace Elements / administration & dosage

Substances

  • Hemoglobins
  • Trace Elements
  • Iron