Iron-Deficiency Anemia and Weight at Birth, Length of Gestation and Perinatal Mortality?

An extensive literature review was conducted to identify whether iron deficiency, iron-deficiency
anemia and anemia from any cause are causally related to low birth weight, preterm birth or perinatal mortality.
As part of a critical review process to examine the importance of iron deficiency and iron-deficiency anemia and anemia in public health, this review was undertaken to determine whether these conditions in pregnant women cause low birth weight (LBW) or perinatal mortality. Because LBW (,2.5 kg at birth) infants include both those who are preterm (,37 wk gestational age) and those who are small for their gestational age, the distinction between preterm and fetal growth retardation
was maintained where the data permitted.
For the intervention studies to demonstrate a causal relationship between correction of maternal anemia and an increase in birth weight, a number of conditions must be met. For the purpose of this review, these factors fall into three broad categories, i.e., those that eliminate confounding and bias, those that permit one to attribute the effect observed to
the elimination of anemia, iron deficiency or both, and those that eliminate false-negative findings.
Consideration should be given to lowering the hemoglobin cut-off value for anemia during pregnancy because optimal birth outcomes may be achieved at hemoglobin values in the range currently designated as anemic. Although there may be other reasons to offer women supplemental iron during pregnancy, the currently available evidence from studies with designs appropriate to establish a causal relationship is insufficient to support or reject this practice for the specific purposes of raising birth weight or lowering the rate of preterm birth.
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