USPSTF: Inconclusive on Iron Supplementation in Pregnancy; Urgent Reassessment Needed

The United States Preventative Services Task Force (USPSTF) finds inconclusive evidence for routine iron supplementation in pregnant women with iron deficiency anemia, despite its high prevalence. However, robust studies link early infancy iron deficiency to long-term cognitive deficits. Although the US doesn’t routinely screen infants, UK guidelines advise screening high-risk infants. A study of non-anemic, first-trimester pregnant women found a significant portion iron deficient, suggesting universal screening’s potential benefits, prompting reconsideration of USPSTF recommendations.

The discrepancy between USPSTF recommendations and evidence of cognitive deficits in early iron-deficient infants calls for reassessment. Despite the US’s lack of routine screening, a substantial portion of non-anemic, first-trimester women were found iron deficient, indicating a missed opportunity for intervention. Considering the absence of harm and potential long-term consequences, a more proactive screening approach seems prudent, urging a reevaluation of USPSTF recommendations for optimal maternal and infant health outcomes.

Reference: Auerbach M, Abernathy J, Juul S, Short V, Derman R. Prevalence of iron deficiency in first trimester, nonanemic pregnant women. J Matern Fetal Neonatal Med. 2021 Mar;34(6):1002-1005. doi: 10.1080/14767058.2019.1619690. Epub 2019 Jun 3. PMID: 31154873.

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