This article is more than 5 years old. Information may no longer be current.
USPSTF: Insufficient evidence exists for anemia testing, iron supplementation in pregnant women
Click Here to Manage Email Alerts
The U.S. Preventive Services Task Force reported that insufficient evidence exists regarding routine screening for iron deficiency anemia and the benefits and risks associated with routine iron supplementation in asymptomatic pregnant women, according to a clinical guideline published in Annals of Internal Medicine.
Therefore, the USPSTF did not issue a recommendation supporting or discouraging iron deficiency screening in this population. This statement follows draft recommendations released in April that stated there is not enough evidence available to recommend for or against screening for iron deficiency anemia or routine iron supplementation in pregnant women and young children.
“The aims of iron supplementation or screening for and treatment of iron deficiency anemia in pregnant women are to improve maternal and infant health outcomes,” Albert L. Siu, MD, MSPH, professor and system chair of geriatrics and palliative medicine and professor of population health science and policy at Mount Sinai Hospital, wrote on behalf of the USPSTF. “Few data are available to estimate the current prevalence of iron deficiency anemia in pregnant women in the U.S. Based on older data from 1999 to 2006, 18.6% of pregnant women have iron deficiency; of those, an estimated 16.2% have anemia.”
The USPSTF recommended that asymptomatic pregnant women should undergo routine screening for iron deficiency anemia in 2006.
Siu and colleagues reviewed evidence on the association between change in iron status as a result of intervention with an oral supplement or treatment in pregnant women and adolescents, as well as the improvement of maternal and infant health outcomes.
The researchers found inadequate evidence on screening for iron deficiency anemia among asymptomatic pregnant women. No studies assessed the direct effects of routine screening on maternal health or birth outcomes.
Further, they found inadequate evidence on the treatment of iron deficiency anemia in pregnant women, because of a lack of recent studies on treatment published data generalizable to the general U.S. population.
The USPSTF found little evidence on the effect of routine iron supplementation during pregnancy on maternal health or birth outcomes, such as maternal iron deficiency anemia, Cesarean delivery, preterm delivery, infant mortality or low birthweight. Inconsistencies also persisted in the available studies.
Further, inadequate evidence existed regarding whether routine iron supplementation during pregnancy improved intermediate maternal hematologic indexes, including serum ferritin and hemoglobin levels.
The researchers found no studies that directly evaluated the association between change in iron status as a result of treatment or supplementation and improvement in maternal or infant health outcomes.
However, the USPSTF determined that adequate evidence exists to suggest that the magnitude of harms of routine iron supplementation in pregnant women is small to none. Most studies reported no statistically significant increase in adverse events among pregnant women receiving iron supplementation.
The USPSTF noted that their recommendations do not address pregnant women who are malnourished, are symptomatic for iron deficiency anemia, or who have hematologic conditions or nutritional needs that may increase their need for iron.
“Although the 2006 statement recommended screening for iron deficiency anemia in pregnant women, the current recommendation found insufficient evidence to recommend for or against screening,” Siu and colleagues wrote. “In its review of the evidence to update the 2006 recommendation, the USPSTF found no good- or fair-quality studies on the benefits or harms of screening that would be applicable to the current U.S. population of pregnant women.” – by Cameron Kelsall
Disclosure: Siu reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.
Click Here to Manage Email Alerts