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December 15, 1993

Routine Iron Supplementation During PregnancyPolicy Statement

JAMA. 1993;270(23):2846-2848. doi:10.1001/jama.1993.03510230084041

SUMMARY OF RECOMMENDATION  There is currently little evidence from published clinical research to suggest that routine iron supplementation during pregnancy is beneficial in improving clinical outcomes for the mother, fetus, or newborn. The evidence is insufficient to recommend for or against routine iron supplementation during pregnancy ("C" recommendation). Although observational data (grade II-2 evidence) suggest that pregnant women with anemia (hemoglobin level less than 100 g/L) are at increased risk of preterm birth, low birth weight, and other adverse outcomes, it is unclear from such evidence whether anemia is responsible for these outcomes and whether they can be prevented through iron supplementation. Similarly, it is unclear whether iron supplementation during pregnancy can reduce the incidence of iron deficiency in infants, a condition that has been associated with delayed psychomotor development. Although iron supplementation can improve maternal hematologic indexes, controlled clinical trials (grade I and II-1 evidence) have failed to demonstrate