A "conservative" approach to iron supplementation during pregnancy

A review of current knowledge about iron metabolism during pregnancy and th e evidence from various studies on the effects of iron supplementation in p regnancy on maternal, fetal, and infant outcomes suggest that the implicit goal of current recommendations regarding iron supplementation may be to ac hieve the highest hemoglobin concentration possible. This goal is only weak ly related to improved maternal and infant outcomes in the current pregnanc y or to improved maternal iron stores long-term. Indeed, the claim that iro n supplementation is universally innocuous is shown to be controversial. Fo r women in developed countries who are generally clinically healthy and hav e access to adequate nutrition, the benefits of iron supplementation are un clear, and there may be risks. Thus, a better "conservative" approach may b e that such women do not require routine iron supplementation during pregna ncy. The midwifery philosophy of individualizing care based on a woman's hi story and health status: is one that should be taken in approaching the iss ue of iron supplementation in pregnancy. (C) 2001 by the American College o f Nurse-Midwives.