ObjectivesThe objectives were to identify the prevalence of iron deficiency and anemia in pregnancy and to define the normal hemoglobin range in iron-replete women.Secondary outcomes included defining hemoglobin ranges by gestational age, identifying the prevalence of postpartum anemia, and evaluating the role of MCV for identifying iron deficiency. MethodsA retrospective review of laboratory results from 1239 pregnant women without hemoglobinopathy was performed.Measurement of hemoglobin, iron studies, and ferritin were performed with routine gestational diabetes screening.Anemia was defined as hemoglobin <110 g/L.Iron deficiency was defined as ferritin <30 g/L and/or iron percent saturation <16%.Means and standard deviations or medians and interquartile ranges were calculated, as appropriate. Results89% (1102/1239) of women were iron deficient.Of the 7% (89/1239) who were anemic, 94% (84/89) were iron deficient.Mean gestational age was 26.2 (SD 2.7) weeks.Median hemoglobin was 121 g/L (IQR 10, range 92-150g/L).Median hemoglobin in the 137 iron replete women was 124 g/L (IQR 9, range 100-147g/L).After excluding the bottom 5%, the lower limit of hemoglobin in iron replete women was 110 g/L.J o u r n a l P r e -p r o o f How to incorporate into clinical practice Ferritin assessment should be routine with prenatal bloodwork J o u r n a l P r e -p r o o f A hemoglobin level below 110 g/L in pregnancy always warrants investigation Oral iron supplementation should be routine in pregnancy
MacKinnon et al. (Wed,) studied this question.