John Beard

Summary Iron deficiency continues to be one of the most prevalent nutritional deficiency diseases in the world and has a particularly high prevalence in pregnancy. The incidence and severity are greater in developing countries but even in developed countries, the prevalence may reach 30-40% in the third trimester. The assessment of iron status in pregnancy can be challenging due to the rapid expansion of the maternal blood volume and then rapid fetal and placental growth. The recommendation for iron intervention is based on a multibiomarker approach that includes serum ferritin, soluble transferrin receptor, transferrin saturation, and hemoglobin. There are significant negative outcomes to iron deficiency in pregnancy; these include maternal and infant mortality in severe cases, but also shortened gestation, prematurity, and poorer infant development in less severe cases. A substantial scientific and medical literature shows a substantial adverse outcome to iron deficiency in the first trimester, with additive risk if the iron deficiency persists throughout pregnancy. Infants born to iron-deficient mothers are more likely to become iron deficient themselves in early postnatal life; this in turn, appears to be causally related to delayed neuron maturation. The reversibility of the cognitive and behavioral deficits that occur due to iron deficiency between 6-12 months of postnatal life is questionable and is the subject of several current research projects.

Keywords: Iron deficiency, Ferritin, Transferrin receptor, Neurodevelopment

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