A practical review of iron deficiency in pregnancy

Iron deficiency is a highly prevalent nutritional deficiency and the most common cause of anemia worldwide. Pregnant individuals are particularly susceptible due to increased demands to support expanding maternal blood volume and fetal growth. Iron deficiency and iron deficiency anemia are associated with maternal and neonatal morbidity, including preterm birth, preeclampsia, postpartum hemorrhage, and low birth weight. Iron is essential to support the rapidly growing fetal brain. Maternal iron deficiency is linked to cognitive delays, motor impairment, and neuropsychiatric disease in the offspring with effects lasting beyond childhood. Despite its high prevalence and profound clinical implications, it remains underdiagnosed and undertreated in pregnancy. This is potentiated by a lack of consensus regarding laboratory diagnosis and recommendations for screening and treatment. Here, we review the physiology, clinical implications, diagnosis, and treatment of iron deficiency in pregnancy.