Lena Volland: Screening Gaps and Clinical Outcomes of Iron Deficiency Anemia in Pregnancy
Lena Volland, Founder and CEO of FlowLab, shared a post on LinkedIn about a recent article by Arafat Ul Alam et al, adding:
“Iron deficiency anemia (IDA) during pregnancy is common, yet we still do not screen for and treat it effectively.
A large population-based cohort study by Alam et. al. of more than 200,000 pregnant people in Canada found that:
- 18 percent developed IDA
- 24 percent in the bleeding disorder subgroup developed IDA
- Among pregnant people with IDA, only one in three had ferritin checked
- Less than 10 percent of IDA cases were corrected during pregnancy
Maternal IDA was also associated with preterm birth, low birth weight, cesarean delivery, and increased need for blood transfusions.
For people with inherited bleeding disorders, this issue may be even more significant.
Many people begin pregnancy with depleted iron stores due to heavy menstrual bleeding, yet screening and monitoring remain inconsistent.
So why are we missing something that is common, detectable, and treatable?
Part of the answer may lie in the system itself.
Clinical guidelines vary on whether ferritin screening should be routine, hemoglobin is often used as a surrogate for iron deficiency, and prenatal care workflows may not prioritize repeat monitoring even as iron deficiency becomes more common later in pregnancy.
But for many people, iron deficiency predates pregnancy, a consequence of a system that routinely dismisses bleeding symptoms, under-recognizes early iron loss, and prioritizes treatment over prevention.
In other words, this is likely less a knowledge problem and more an implementation problem.
It will be interesting to see how updated clinical recommendations and their dissemination will impact these outcomes.”
Title: Suboptimal screening and correction of maternal iron deficiency anaemia in the general population and in inherited bleeding disorders: A population-based cohort study
Authors: Arafat Ul Alam, Padma Kaul, Venu Jain, Cynthia Wu, Haowei (Linda) Sun
Read the Full Article on British Journal of Haematology
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