Recommended Daily Iron Intake for Pregnant Women
Pregnant women require 27 mg of iron daily according to the Institute of Medicine recommendations, making the correct answer none of the options provided (A-D are all too low). 1
Standard Iron Requirements During Pregnancy
The established daily requirement is 27 mg of elemental iron for all pregnant women, which reflects the significant increase in iron needs due to fetal development, placental growth, and expanded maternal erythrocyte mass. 1
Prenatal vitamins typically contain 30 mg of elemental iron, which exceeds the minimum requirement and is the usual dose prescribed in early pregnancy. 1
Most pregnant women (77%) report using multivitamin supplements containing approximately 48 mg of iron, which provides an adequate safety margin above the baseline requirement. 1
Higher Doses for Specific Clinical Situations
The 27 mg baseline requirement increases substantially when iron deficiency or anemia is present:
For women at higher risk of iron deficiency anemia (but not yet anemic), 60-100 mg elemental iron daily should be prescribed. 1
For treatment of established iron deficiency anemia, 60-120 mg of elemental iron per day is required, which is the first-line therapy recommended by the American Academy of Family Physicians and American College of Obstetricians and Gynecologists. 2, 3
Special Population Considerations
Women with vegetarian diets may require almost twice as much iron (approximately 50-54 mg daily) since nonheme iron from plant sources is less well absorbed than heme iron from animal sources. 1, 2
Non-Hispanic Black and Mexican American women have higher prevalence rates of iron deficiency and may benefit from the higher prophylactic dose of 60-100 mg daily. 1, 2
Women with short intervals between pregnancies are at higher risk for iron deficiency and should receive closer monitoring with consideration for higher supplementation doses. 1, 2
Practical Implementation
For routine prophylaxis in women with adequate iron stores: Prenatal vitamin with 30-48 mg elemental iron daily, taken at bedtime to minimize gastrointestinal side effects. 1
Calcium supplements and antacids decrease iron absorption and must be taken at different times of day from iron supplementation. 1, 2
Monitor response with repeat hemoglobin/hematocrit testing after 4 weeks of treatment when treating anemia. 2, 3
Continue iron supplementation throughout pregnancy and the postpartum period to prevent recurrence of deficiency. 2, 3