Am J Clin Nutr. 2017 Dec;106(Suppl 6):1655S-1662S. doi: 10.3945/ajcn.117.156000. Epub 2017 Oct 25.

Iron status in pregnant women and women of reproductive age in Europe

Milman N1,2, Taylor CL3, Merkel J3, Brannon PM3,4.

Author information

1 – Departments of Clinical Biochemistry and
2 – Obstetrics, Naestved Hospital, University College Sjaelland, Naestved, Denmark.
3 – Office of Dietary Supplements, NIH, Bethesda, MD; and.
4 – Division of Nutritional Sciences, Cornell University, Ithaca, NY.


Understanding the iron status in pregnant women in Europe provides a foundation for considering the role of iron screening and supplementation. However, available reports and studies have used different approaches that challenge the devising of overall summaries. Moreover, data on pregnant women are limited, and thus, data on women of reproductive age provide useful background information including baseline iron stores in pregnant women. This review considered data that are available from >15 European countries including national surveys and relevant clinical studies. In European women of reproductive age, median or geometric mean serum ferritin (SF) concentrations were estimated at 26-38 μg/L. Approximately 40-55% of this population had small or depleted iron stores (i.e., SF concentration ≤30 μg/L), and 45-60% of this population had apparently replete iron stores. The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) was 10-32% and 2-5%, respectively, depending on the cutoffs used. Approximately 20-35% of European women of reproductive age had sufficient iron stores (SF concentration >70 μg/L) to complete a pregnancy without supplementary iron. During pregnancy, European women in controlled supplementation trials who were not receiving iron supplements displayed increasing prevalences of ID and IDA during pregnancy, which peaked in the middle to late third trimester. Available evidence has suggested that, in gestational weeks 32-39, the median or geometric mean SF concentrations were 6-21 μg/L, and prevalences of ID and IDA were 28-85% and 21-35%, respectively. Women who were taking iron supplements had higher iron status and lower prevalences of ID and IDA, which were dependent on the dose of iron and compliance. The data suggest that, in Europe, the iron status of reproductive-aged women varies by region and worsens in pregnancy without iron supplementation.

KEYWORDS: European women; iron deficiency; iron deficiency anemia; iron overload; iron replete; iron status; pregnancy; premenopausal women

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