September 2015 Task Force FINAL Recommendation | 1
Understanding Task Force Recommendations
Screening for Iron Deficiency Anemia and Iron Supplementation in
Pregnant Women to Improve Maternal Health and Birth Outcomes
The U.S. Preventive Services Task Force (Task Force)
has issued a final recommendation statement on
Screening for Iron Deficiency Anemia and Iron
Supplementation in Pregnant Women to Improve
Maternal Health and Birth Outcomes.
This final recommendation statement applies to
pregnant adolescents and women who do not have
signs or symptoms of iron deficiency or iron deficiency
anemia (IDA).
The Task Force reviewed research studies on the
potential benefits and harms of screening all pregnant
women for IDA. It also looked at studies on the
benefits and harms of all pregnant women taking an
iron supplement. The final recommendation statement
summarizes what the Task Force learned: Based on
available evidence, there is not enough information on
the benefits and harms of routine IDA screening in
pregnant women to recommend for or against
screening. There also is not enough information on the
benefits and harms of iron supplements to make a
recommendation.
What is iron deciency
anem i a?
Iron deficiency anemia is a condition in which the body does not
have enough iron to build healthy red blood cells. Red blood cells
are needed to carry oxygen throughout the body.
Facts about Iron Deficiency Anemia
Iron plays an important role in keeping a person healthy. Red blood cells need iron to be able to carry oxygen throughout
the body. Most people get enough iron from a healthy diet.
At certain times—such as during pregnancy—the body needs more iron than usual. Often, the body can get the extra iron it
needs by increasing the amount of iron absorbed from food or a woman can eat more iron-rich foods.
IDA happens when the body does not have enough iron and the blood cannot carry oxygen throughout the body as efficiently.
Often, someone with IDA will not have signs or symptoms. When present, the most common symptom is fatigue; others include
shortness of breath, dizziness, headaches, and chest pain.
Several factors can increase the chances of developing IDA. These include eating a diet that doesn’t have enough iron-rich
foods and having a stomach or intestinal disease or taking a medicine that interferes with the body’s ability to take in iron from
food. Having only a short time between pregnancies also can increase the risk of IDA because the woman’s body doesn’t have
enough time to rebuild her iron stores.
September 2015 Task Force FINAL Recommendation | 2
Screening for Iron Deficiency Anemia and Iron Supplementation in
Pregnant Women to Improve Maternal Health and Birth Outcomes
Screening for Iron Deficiency Anemia and Iron Supplementation in Pregnant Women
The goal of screening pregnant women is to detect IDA so it can be treated. Screening is generally done with a blood test. If IDA is found,
it is often recommended that a woman increase her iron intake by eating more iron-rich foods or by taking an iron pill. The goal of iron
supplementation is to raise the levels of iron in the blood by prescribing iron pills to prevent iron deficiency anemia.
Potential Benefits and Harms
The Task Force reviewed evidence on how IDA screening in pregnant women and taking iron supplements affects the health of pregnant
women and their babies. They found no studies that looked at the benefits of routinely screening pregnant women on their long-term
health or birth outcomes (such as cesarean delivery, preterm delivery, infant death, or low birth weight). They found that there was not
enough evidence on whether or not supplementation improves a pregnant woman’s health or her baby’s birth outcomes. They found no
studies that looked at the harms of routine IDA screening. Available studies on routine iron supplementation showed that it likely has few
or mild harms.
The Final Recommendations on Iron Deficiency Anemia Screening and Iron Supplementation in Pregnant
Women: What Do They Mean?
Here are the Task Force’s final recommendations on routine screening for IDA and routine iron supplementation in pregnant women.
Recommendation statements have letter grades. The grades are based on the quality and strength of the evidence about the potential
benefits and harms of screening for this purpose. Task Force recommendation grades are explained in the box at the end of this fact sheet.
When there is not enough evidence to judge benefits and harms, the Task Force does not make a recommendation for or against—it
issues an I Statement. The Notes explain key ideas.
Visit the Task Force Web site to read the full final recommendation statement. The statement explains the evidence the Task Force
reviewed and how it decided on the grade. An evidence document provides more detail about the studies the Task Force reviewed.
September 2015 Task Force FINAL Recommendation | 3
Screening for Iron Deficiency Anemia and Iron Supplementation in
Pregnant Women to Improve Maternal Health and Birth Outcomes
The Task Force concludes that the cur
rent evidence is insufcient
to assess the balance of benefits and harms of screening for
iron deciency anemia in pregnant women to prevent adverse
maternal health and birth outcomes. I Statement
1
The USPSTF concludes that the current evidence is insufcient
to assess the balance of benefits and harms of routine iron
supplementation for pregnant women to prevent adverse maternal
health and birth outcomes. I Statement
2
Notes
1
current evidence is
insufcient
The Task Force did not find
enough information to make a
recommendation for or against
IDA screening.
screening for iron
deciency anemia
Ordering a blood test to determine
if a person is likely to have IDA.
adverse maternal health and
birth outcomes
Negative events, such as
premature birth, low birth weight,
death of the baby soon after birth,
or maternal bleeding after birth.
current evidence is
insufcient
The Task Force did not find
enough information to make a
recommendation for or against
taking iron pills.
routine iron supplementation
Taking iron pills on a regular basis
2
Should You Be Screened for Iron Deficiency Anemia or Take Iron Supplements?
Getting the best health care means making smart decisions about what screening tests, counseling services, and preventive medicines to
get and when to get them. Many people don’t get the tests or counseling they need. Others get tests or counseling they don’t need or that
may be harmful to them.
Task Force recommendations can help you learn about screening tests, counseling services, and preventive medicines. These services can
keep you healthy and prevent disease. The Task Force recommendations do not cover diagnosis (tests to find out why you are sick) or
treatment of disease. Task Force recommendations also apply to some groups but not others. For example, this recommendation applies only
to pregnant adolescents and women.
| 4
Screening for Iron Deficiency Anemia and Iron Supplementation in
Pregnant Women to Improve Maternal Health and Birth Outcomes
Deciding Whether to Get Screened for Iron Deficiency Anemia or to Take
Iron Supplements
Eating a healthy diet with good sources of iron can help prevent iron deficiency.
If you are concerned about your diet or that you may be at risk for IDA, talk with
your doctor or nurse about your concerns. Consider your own health and
lifestyle. Think about your personal beliefs and preferences for health care. And
consider scientific recommendations, like this one from the Task Force.
Your Decision
About Screening
What is the U.S. Preventive Services Task Force?
The Task Force is an independent, volunteer group of national experts in prevention
and evidence-based medicine. The Task Force works to improve the health of all
Americans by making evidence-based recommendations about clinical preventive
services such as screenings, counseling services, and preventive medicines. The
recommendations apply to people with no signs or symptoms of the disease.
To develop a recommendation statement, Task Force members consider the best
available science and research on a topic. For each topic, the Task Force posts draft
documents for public comment, including a draft recommendation statement. All
comments are reviewed and considered in developing the final recommendation
statement. To learn more, visit the Task Force Web site.
USPSTF Recommendation Grades
Grade Definition
A Recommended.
B Recommended.
C Recommendation depends on the patient’s situation.
D Not recommended.
I statement There is not enough evidence to make a recommendation.
Click Here to Learn More
About Iron Deficiency
Anemia
Your Guide to Anemia
(National Heart, Lung, and
Blood Institute)
Iron-Deficiency Anemia
(National Heart, Lung, and
Blood Institute, National
Institutes of Health)
Anemia
(MedlinePlus)
September 2015 Task Force FINAL Recommendation
