The assessment of iron deficiency in pregnancy.

Abstract

Serial observations were made on two groups of women from early pregnancy to term to assess the effect of pregnancy on the iron status. The first group had no evidence of iron deficiency in early pregnancy and were not given supplementary iron. The second group of patients were a random selection and each patient was given a regular supply of iron tablets. The cooperation of the patient in taking the iron was verified by stool tests. The measurements of the serum iron, total iron binding capacity (transferrin), and erythrocyte porphyrins in addition to the other haematological investigations indicated that in the patients not given iron and those who did not take the supplementary iron the haemoglobin level gradually decreased, and iron deficiency was present. In the patients regularly taking supplementary iron the haemoglobin level was over 12 g. per 100 ml. at term, and the biochemical findings showed no evidence of iron deficiency. The total iron-binding capacity gradually increased during pregnancy with and without iron deficiency. Red cell morphology and the mean haemoglobin concentration were not sensitive indices of iron deficiency. The results of the study suggest that ‘physiological’ anaemia does not exist in pregnancy and reduced haemoglobin values in late pregnancy are most likely the result of an inadequate iron intake.