Iron deficiency anaemia is a common clinical problem in pregnant women worldwide. It affects around 15–20% of women in high-income countries and up to 50% in low-income and middle-income countries. 1 WHO
Prevalence of anaemia in pregnant women (aged 15–49) (%). Iron deficiency anaemia is a risk factor for postpartum haemorrhage, blood transfusion, infection, preterm birth, small-for-gestational-age babies, difficulties with breastfeeding, impaired quality of life, and, in severe cases, maternal death. 2 Benson CS Shah A Stanworth SJ et al. The effect of iron deficiency and anaemia on women's health.

Anaesthesia. 2021; 76: 84-95

Oral iron supplementation is the first-line treatment during pregnancy, although gastrointestinal side-effects can lead to suboptimal patient adherence. Additionally, restoration of haemoglobin and iron stores takes several weeks, which might limit its use in late pregnancy. Intravenous iron has a role for women with severe anaemia, in women who are non-adherent or cannot tolerate oral iron, and in late pregnancy. 3 Pavord S Daru J Prasannan N et al. UK guidelines on the management of iron deficiency in pregnancy.

Br J Haematol. 2020; 188: 819-830

Intravenous iron is not recommended in the first trimester because of concerns about fetal development. Intravenous iron use in women of reproductive age has increased rapidly with the availability of newer preparations with shorter administration times and increasing recognition of the importance of iron deficiency anaemia. 4 Shand AW Bell J Henry A et al. Rapid increase in intravenous iron therapy for women of reproductive age in Australia.

Med J Aust. 2020; 213: 85-86