Iron-Deficiency Anemia:
Reexamining the Nature and
Magnitude of the Public Health Problem
An extensive
literature review was conducted to identify whether iron deficiency,
iron-deficiency anemia and anemia from any cause are causally related to low
birth weight, preterm birth or perinatal mortality. Strong evidence exists for
an association between maternal hemoglobin concentration and birth weight as
well as between maternal hemoglobin concentration and preterm birth. It was not
possible to determine how much of this association is attributable to
iron-deficiency anemia in particular. Minimal values for both low birth weight
and preterm birth occurred at maternal hemoglobin concentrations below the
current cut-off value for anemia during pregnancy (110 g/L) in a number of
studies, particularly those in which maternal hemoglobin values were not
controlled for the duration of gestation. Supplementation of anemic or
nonanemic pregnant women with iron, folic acid or both does not appear to
increase either birth weight or the duration of gestation. However, these
studies must be interpreted cautiously because most are subject to a bias
toward false-negative findings. Thus, although there may be other reasons to
offer women supplemental iron during pregnancy, the currently available
evidence from studies with designs appropriate to establish a causal
relationship is insufficient to support or reject this practice for the
specific purposes of raising birth weight or lowering the rate of preterm
birth. J. Nutr. 131:590S– 603S, 2001.
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