From the Guidelines
The recommended daily intake of elemental iron during pregnancy is 27 mg per day. This is higher than the 18 mg recommended for non-pregnant women because pregnancy increases iron requirements significantly. During pregnancy, a woman's blood volume expands by about 50%, requiring more iron to produce additional red blood cells. Iron is also essential for the developing fetus and placenta, and helps build iron stores for the baby's first few months of life. Many prenatal vitamins contain this amount of iron, but some women with iron deficiency anemia may need higher supplementation (typically 60-120 mg of elemental iron daily) as prescribed by their healthcare provider. According to the Institute of Medicine, the Recommended Dietary Allowance for iron in pregnant women is 27 mg per day 1.
Some key points to consider:
- Iron is best absorbed when taken on an empty stomach with vitamin C (such as orange juice), though it can be taken with food if stomach upset occurs.
- Common side effects of iron supplements include constipation, nausea, and dark stools.
- Women should avoid taking iron with calcium supplements, dairy products, coffee, or tea, as these can reduce absorption.
- Natural food sources of iron include certain fruits, vegetables, meat, and poultry, and fortified breads and grain products (such as cereal) are also important potential sources of iron.
- The Institute of Medicine also notes that nonheme iron, which is found in vegetarian diets, may be less well-absorbed than heme iron, which is found in diets containing meat; therefore, the iron requirement may be almost twice as much in women who eat a purely vegetarian diet.
From the Research
Recommended Daily Intake of Elemental Iron During Pregnancy
The recommended daily intake of elemental iron during pregnancy is a crucial aspect of prenatal care. According to the studies, the following points are relevant:
- A daily dose of 30 mg of elemental iron is recommended for pregnant women to improve their iron status and reduce the risk of iron-deficiency anemia in their infants 2.
- Higher doses of iron are not recommended due to potential negative effects on mineral absorption, oxidative pathways, and adverse gastrointestinal symptoms 2.
- The World Health Organization (WHO) recommends a daily intake of 30-60 mg of elemental iron for pregnant women, depending on the prevalence of anemia in the population 3, 4.
- Some studies suggest that doses of 60 mg of elemental iron or higher may increase the risk of side effects, such as gastrointestinal symptoms 3, 4.
- The American College of Obstetricians and Gynecologists (ACOG) recommends a daily intake of 27 mg of elemental iron for pregnant women, which is in line with the Dietary Reference Intake (DRI) established by the National Academies of Sciences, Engineering, and Medicine 5.
Key Findings
Some key findings from the studies include:
- Daily oral iron supplementation during pregnancy reduces the risk of maternal anemia and iron deficiency at term 3, 4, 5.
- Iron supplementation may also reduce the risk of low birthweight and preterm birth, although the evidence is not conclusive 3, 4, 5.
- High doses of iron may have negative effects on maternal and infant health, highlighting the need for careful consideration of iron supplementation regimens 2, 6.
Considerations for Iron Supplementation
When considering iron supplementation during pregnancy, the following points are important:
- Iron supplementation should be tailored to individual needs, taking into account the woman's iron status and the prevalence of anemia in the population 3, 4.
- The risks and benefits of iron supplementation should be carefully weighed, particularly in women with high iron status or those at risk of adverse effects 2, 6.
- Further research is needed to determine the optimal dose and regimen of iron supplementation during pregnancy, as well as its effects on maternal and infant health outcomes 5, 6.