USPSTF Recommendation Statement Addresses Iron Deficiency Anemia in Pregnancy

Current evidence is insufficient to determine the benefits and harms of routine screening and supplementation for iron deficiency and iron deficiency anemia in pregnant persons, according to a new recommendation statement from the U.S. Preventive Services Task Force (USPSTF) published in JAMA.

The USPSTF is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine that aims to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services.

The USPSTF commissioned a systematic review to evaluate the impact of screening and iron supplementation on maternal and infant health outcomes in asymptomatic pregnant individuals. Findings revealed a lack of conclusive data to support or oppose preventive iron supplementation during pregnancy, despite the practice being common for decades. As a result, the USPSTF issued an "insufficient evidence statement," indicating that they cannot assess the balance of benefits and harms for either intervention.

The statement encouraged clinicians to weigh the risks and benefits of iron supplementation and screening on a case-by-case basis, particularly for populations more susceptible to iron deficiency anemia. Recent data suggest that Black and Mexican American pregnant individuals are disproportionately affected by iron deficiency anemia, potentially due to social determinants of health. However, the USPSTF noted that the current evidence is limited, with no universally accepted cutoffs for diagnosing iron deficiency, and hematologic indices often used as proxies in place of iron biomarkers. The USPSTF emphasized the need for more research to better understand the burden of iron deficiency and to develop more reliable screening and treatment guidelines.