Oral Iron Supplementation in Pregnancy: Current Recommendations and Evidence-Based Medicine

Abstract

Objective To review the evidence about universal iron supplementation in pregnancy to prevent maternal anemia.

Methods Bibliographic research of randomized and controlled clinical trials, meta-analyses, systematic reviews, and clinical guidelines, published between August 2009 and August 2019, using the MeSH terms: iron; therapeutic use; pregnancy; anemia, prevention and control.

Results We included six clinical guidelines, three meta-analyses and one randomized controlled clinical trial.

Discussion Most articles point to the improvement of hematological parameters and reduction of maternal anemia risk, with supplementary iron. However, they do not correlate this improvement in pregnant women without previous anemia with the eventual improvement of clinical parameters.

Conclusion Universal iron supplementation in pregnancy is controversial, so we attribute a SORT C recommendation strength.

Resumo

Objetivo Rever a evidência sobre a necessidade de suplementação universal de ferro na gravidez para prevenção de anemia materna.

Métodos Pesquisa bibliográfica de ensaios clínicos aleatorizados e controlados, metanálises, revisões sistemáticas e normas de orientação clínica, publicados entre agosto de 2009 e agosto de 2019, utilizando os termos MeSH: iron, terapêuticas use; pregnancy; anemia, preventivos and control.

Resultados Incluímos seis normas de orientação clínica, três metanálises e um ensaio clínico randomizado e controlado.

Discussão A maioria dos artigos aponta para a melhoria dos parâmetros hematológicos e redução do risco de anemia materna por meio da suplementação com ferro. Todavia, eles não correlacionam a melhoria destes parâmetros em grávidas sem anemia prévia com a eventual melhoria de parâmetros clínicos.

Conclusões A suplementação universal com ferro na gravidez é controversa, pelo que atribuímos uma força de recomendação SORT C.

Keywords

iron - dietary supplements - pregnancy - anemia - prenatal care

Palavras-chave

ferro - suplementação nutricional - gravidez - anemia - cuidado prey-natal

Contributions

All authors participated in the concept and design of the present study; analysis and interpretation of data; draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.

Publication History

Received: 20 October 2020

Accepted: 05 August 2021

Article published online:
16 November 2021

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