National Panel Says Evidence Lacking To Support Iron Deficiency Screening in Pregnancy

In an Aug. 20 statement, the U.S. Preventive Services Task Force (USPSTF) declined to recommend routine screening or the use of iron supplements for iron deficiency and iron deficiency anemia during pregnancy, saying evidence is insufficient to support such recommendations.

Iron deficiency is the leading cause of anemia during pregnancy in the U.S. It is estimated that iron deficiency affects 18% of pregnant women and that iron deficiency anemia affects 5% of pregnant women, although disparities exist by race, ethnicity, and social factors (e.g., food insecurity, socioeconomic status).

Anemia is a blood disorder that occurs when the body does not produce enough healthy red blood cells or hemoglobin (a protein containing iron that facilitates the transport of oxygen in blood cells) to carry oxygen throughout the body. Iron is required for the production of hemoglobin and is also needed in the production of additional proteins necessary to various metabolic pathways.

Seeking to update a 2015 statement, the USPSTF commissioned a systematic review of current evidence on screening and the use of iron supplements for iron deficiency anemia during pregnancy. The update also included a broadened review to include iron deficiency without anemia.

The USPSTF said its review found insufficient evidence to assess the balance of benefits and harms of routine screening for iron deficiency and iron deficiency anemia during pregnancy. The task force also said the evidence showed no significant differences in maternal health outcomes such as cesarean-section delivery and hypertensive disorders between pregnant women who received routine iron supplementation and those who did not.

Under the Affordable Care Act’s definition of covered preventive services, certain health plans are required to provide coverage for services with a USPSTF recommendation grade of “A” or “B,” the task force’s highest and second-highest recommendations, respectively. As it did in 2015, the USPSTF on Aug. 20 gave “I” grades (for “insufficient” evidence) to routine anemia screening and routine iron supplementation.

The USPSTF is an independent, volunteer panel of national health experts in disease prevention and evidence-based medicine. We wrote in a previous post about the task force’s recommendation that women receive blood pressure checks throughout pregnancy.

For more on maternal and infant health in Arkansas, see our topic page.