In 1998 the Centers for Disease Control issued a special set of recommendations on treating iron deficiency in the U.S., paying particular attention to the need for supplemental iron intake by pregnant women in order to minimize the risk for preterm delivery and the delivery of a low-birth-weight baby. Because many women in the U.S. of childbearing age struggle with iron deficiency even when not pregnant, highlighting the particular importance of iron supplements during pregnancy is a critical public health measure not only in the U.S. but all over the world.
Why Your Body Needs Iron
Iron works in the human body as an oxygen carrier from the lungs to tissues in the form of hemoglobin; as a facilitator for oxygen storage and use in muscles; as a medium of transport for electrons within the cells and as an important element of enzyme reactions that take place in a variety of tissues. According to the CDC, too little iron can interfere with these vital functions and lead to near death and death.
More Iron Needed as Your Blood Volume, Placenta Grow
During pregnancy, a woman's iron needs increase for several reasons. Her blood volume expands by approximately 35 percent; the growth of the fetus, placenta, and other maternal tissues triples her needs for iron during her second and third trimesters, to approximately 5.0 mg of iron each day. Critically, most pregnant women who don't take iron supplements during pregnancy cannot maintain adequate iron stores, especially during the second and third trimesters. The CDC warns that "among pregnant women, iron-deficiency anemia during the first two trimesters of pregnancy is associated with a twofold increased risk for preterm delivery and a threefold increased risk for delivering a low-birthweight baby."
Reasons U.S. Pregnancy Iron Supplementation Needs Attention
Research cited by the CDC found that sometimes iron supplementation isn't recommended during pregnancy because sometimes health-care providers and patients don't realize that taking the supplements improves both maternal and infant outcomes. Other challenges to making supplementation more common are complicated dose schedules and uncomfortable side effects.
Improving U.S. Pregnancy Iron Supplementation
Fortunately, lower-dose supplementation regimens that meet the pregnancy requirements of 30 mg of iron per day have been found to be as effective in preventing anemia as higher dose regimens, with the added benefit of reduced unwanted side effects. Simplified dose schedules requiring just one dose a day could also improve compliance.
Global Challenges to Pregnancy Iron Supplementation
A 2010 effort by the organization Micronutrient Initiative is underway to study why anemia prevalence in pregnant women where MI works in Bangladesh, India, Indonesia and Pakistan continues, despite almost all of the countries having iron supplementation for pregnant women in their health policies and including iron products in standard drug lists. Getting an answer to why maternal health is not responding to public policy is urgent; already some researchers have found that doses of iron used was higher than that recommended by the World Health Organization, potentially causing frequent adverse effects such as heartburn and cramping.
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