Evidence is still lacking for iron deficiency screening in pregnancy

The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to weigh the balance of benefits and harms for recommending screening for iron deficiency and iron deficiency anemia in pregnancy. These findings form the basis of a final recommendation statement published in JAMA.

Amy G. Cantor, M.D., M.P.H., from the Oregon Health & Science University in Portland, and colleagues conducted a systematic review to update the 2015 USPSTF recommendations on screening for iron deficiency anemia and iron deficiency during pregnancy. Data were included from 17 trials (24,023 participants).

The researchers found that based on four and six trials, iron supplementation was associated with a reduced risk for maternal iron deficiency anemia at term (relative risk, 0.40) and maternal iron deficiency at term (relative risk, 0.47) compared with placebo or no iron supplement. Compared with placebo or no supplementation, maternal iron supplements were not associated with maternal or infant adverse effects. Transient gastrointestinal adverse effects were harms of iron supplementation.

Based on these findings, the USPSTF concludes that the current evidence is insufficient for assessing the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in asymptomatic pregnant women (I statement). In addition, the current evidence is insufficient for ascertaining the balance of benefits and harms of iron supplementation in asymptomatic pregnant women on maternal and infant health outcomes (I statement).

"We don't have the evidence we need to determine whether or not screening for iron levels or using iron supplements improve health, so we are calling for more research on both these important topics," USPSTF member Esa Davis, M.D., M.P.H., said in a statement

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