Iron-Deficiency Anemia: Reexamining the Nature and
Magnitude of the Public Health Problem
Magnitude of the Public Health Problem
Kathleen M. Rasmussen
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853.
ABSTRACT
An extensive literature review was conducted to
identify whether iron deficiency, iron-deficiency anemia and anemia from any
cause are causally related to low birth weight, preterm birth or perinatal
mortality.
Strong evidence exists for an association between
maternal hemoglobin concentration and birth weight as well as between maternal
hemoglobin concentration and preterm birth. It was not possible to determine
how much of this association is attributable to iron-deficiency anemia in
particular. Minimal values for both low birth weight and preterm birth occurred
at maternal hemoglobin concentrations below the current cut-off value for
anemia during pregnancy (110 g/L) in a number of studies, particularly those in
which maternal hemoglobin values were not
controlled for the duration of gestation. Supplementation of anemic or nonanemic pregnant women with iron, folic acid or both does not appear to increase either birth weight or the duration of gestation. However, these studies must be interpreted cautiously because most are subject to a bias toward false-negative findings. Thus, although there may be other reasons to offer women supplemental iron during pregnancy, the currently available evidence from studies with designs appropriate to establish a causal relationship is insufficient to support or reject this
practice for the specific purposes of raising birth weight or lowering the rate of preterm birth. J. Nutr. 131: 590S–603S, 2001.
controlled for the duration of gestation. Supplementation of anemic or nonanemic pregnant women with iron, folic acid or both does not appear to increase either birth weight or the duration of gestation. However, these studies must be interpreted cautiously because most are subject to a bias toward false-negative findings. Thus, although there may be other reasons to offer women supplemental iron during pregnancy, the currently available evidence from studies with designs appropriate to establish a causal relationship is insufficient to support or reject this
practice for the specific purposes of raising birth weight or lowering the rate of preterm birth. J. Nutr. 131: 590S–603S, 2001.
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