#Irondeficiency is common in pregnancy and about half of women become anaemic.
A normal pregnancy requires about 1000mg of iron for normal baby growth (500mg in the last month when the baby doubles in size). This is a lot of iron and can use a mothers entire reserve stores of iron (held in Ferritin).
A Ferritin below 30 is iron deficiency and can lead to symptoms and anaemia. Often mothers are advised to take oral iron – but is this enough??
In this large clinical trial they compared IV iron infusions with oral iron for women with #irondeficiency, not anaemic, at second trimester (11-20 weeks pregnant).
Intravenous iron for non-anaemic iron deficiency in pregnancy: a multicentre, two-arm, randomised controlled trial: The Lancet Haematology; Volume 13, Issue 1e22-e29January 2026. DOI: 10.1016/S2352-3026(25)00315-1
600 mothers, average 26 years old (23-30) about 65kg (10) with Hb 11·8 (0·6) and Ferritin 14·8 (6·8) received either ORAL iron or IV IRON (1000mg)
Most mothers on ORAL iron were anaemic at delivery compared to a few who had IV iron – (Picture)
Haemoglobin at delivery 11·6 (0·5) 10·8 (0·7) 0·74 (0·64– 0·85) <0·0001 Anaemia before delivery 53/228 (23%) 173/234 (74%) 0·31 (0·25– 0·40)¶ <0·0001 BABIES did better after IV iron, they were heavier and less likely to have poor growth Fetal growth restriction 2/226 (1%) 25/236 (11%) 0·08 (0·02–0·35)† <0·0001 Neonatal birthweight (kg) 3·2 (0·4) 2·9 (0·3) 0·31 (0·25–0·37) <0·0001 In this large, multicentre, randomised trial, in which pregnant women were screened for non-anaemic iron deficiency and given routine prophylactic oral iron supplementation, the addition of 1000 mg intravenous iron to the standard of antenatal care improved maternal haemoglobin concentration before delivery, reduced the development of maternal anaemia, and lowered the rate of fetal growth restriction. SUMMARY - CHECK Ferritin levels in pregnancy and if low then IV iron infusion is the better choice
