Abstract
Early identification of at-risk women and enabled effective management strategies can help prevent the development of iron deficiency and anaemia during pregnancy and postpartum. We used data from the population-based STORK-Groruddalen cohort, which followed women through pregnancy to three months postpartum. Women with ethnic minority background showed an overall poorer iron status compared with Western European women. The overall prevalence of anaemia in early pregnancy was 5.9%, while 25% three months postpartum. We found that 33% had iron deficiency defined by low ferritin concentration early in pregnancy and 39% three months postpartum. In comparison, we observed an overall lower prevalence of iron deficiency defined by elevated soluble transferrin receptor concentration and decreased Total body iron early in pregnancy (6.5%-11%) and postpartum (19%-22%).
South Asian, Middle Eastern and Sub-Saharan African background were associated with higher odds of having anaemia/iron deficiency early in pregnancy. South Asian background, iron deficiency/anaemia early in pregnancy, iron-low diet, self-reported no use of supplementation, primiparity and postpartum haemorrhage were associated with higher odds iron deficiency/anaemia postpartum and being the in “steady low/deteriorated iron status” group postpartum.
Women with low ferritin concentration early in pregnancy were recommended iron supplementation. Later in pregnancy, 65% of these women reported using iron supplementation compared with 26% in the group not exposed to our recommendations. Reported use of iron supplementation was associated with lower odds of postpartum iron deficiency and improved iron stores by all measures, and had higher odds of being in the “steady high/improved iron status” group at the postpartum visit compared with the group reporting no use of supplementation.