Iron deficiency is common during pregnancy. This is especially common amongst pregnant women in the third trimester. Local studies have found that 70% of local women in the third trimester of pregnancy are iron deficient despite most pregnant women already taking multivitamins with some iron supplements in them.
Iron deficiency can be assessed by testing the serum ferritin level. Iron deficiency is not present if the serum ferritin is >= 100 ng/ml. It is present when the serum ferritin level is < 30 ng/ml. For intermediate levels between 30-100 ng/ml, there may still be some benefits towards iron supplementation in some cases especially if there are symptoms of iron deficiency including anaemia, fatigue, brittle nails and hair loss.
We routinely check the ferritin level and full blood count at 28 weeks to check for iron deficiency and for anaemia respectively. If there is iron deficiency and / or anaemia, we would usually advised oral iron supplementation with higher dose iron supplements, and then check the ferritin and haemoglobin levels again in 2-4 weeks. If the response to oral iron supplementation is poor, intravenous iron replacement with the newer preparations which are safe and effective may be considered.
Untreated iron deficiency may predispose to higher risk of postpartum haemorrhage and postpartum depression after delivery.