Is Selective Iron Supplementation Needed During Gestation?

Park, Cheol Hoon; Kweon, In; Lee, Jong Kun; Seo, Keong A; LIm, Heon Woo; Kim, Yong Wook; Lee, Young; Rha, Jong Gu

Abstract

OBJECTIVE
It is controversial whether routine or selective iron supplementation during gestation is needed. The aim of this study is to evaluate whether screening with serum ferritin during the first trimester of pregnancy could be identify women who need prophylactic iron supplementation.
METHODS
According to the serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy and the presence of iron supplementation during gestation, the subject was divided into 4 group that were as follows: serum ferritin level of 30 microgram/L and iron- supplemented group (n=40), serum ferritin level of >30 microgram/L and non iron-supplemented group (n=15). Maternal serum ferritin, TIBC, iron, hemoglobin, hematocrit, red cell indices (MCV, MCH, MCHC, RDW) were measured before 14 weeks of gestation and after 34 weeks of gestation.
RESULTS
All hematologic and biochemical markers indicated more severe anemic status in the late pregnancy than during the first trimester of pregnancy. The effect of iron supplementation was profounder on the pregnant woman whose ferritin levels were below 30 microgram/L during the first trimester of pregnancy. Regardless of iron supplementation, the group (ferritin >30 microgram/L during the first trimester of pregnancy) showed relatively higher ferritin level in late pregnancy.
CONCLUSION
The screening with serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy may be useful to identify women who need prophylactic iron supplementation.