A comparative study of different standards of iron supplementation in pregnant women with iron deficiency in plateau area: A retrospective cohort study from a single center in China

This study investigates the effect of starting iron supplementation with serum ferritin (SF) < 30 μg/L in pregnant women with iron deficiency at Plateau area. This retrospective cohort study included 701 pregnant women with iron deficiency in early pregnancy who delivered in the First People's Hospital of Kunming, China, from January 1, 2022 to July 31, 2023. Iron deficiency was defined as hemoglobin (Hb) ≥ 110 g/L and SF < 30 μg/L during pregnancy. The effect and pregnancy outcome of iron supplementation with SF < 30 μg/L as the standard and Hb < 120 g/L as the standard were compared by statistical methods. Among 701 cases of iron deficiency in the first trimester, 342 cases were given SF < 30 μg/L as the standard of preventive iron supplementation (Group A), and 359 cases were given Hb < 120 g/L as the standard of preventive iron supplementation (Group B). This study found that the Group A had a statistically significant difference in the incidence of anemia and iron deficiency before delivery compared with the Group B (P < .001), and it was found that the Group A had a higher Hb level before delivery (β: 6.693, 95% confidence interval: 5.691-7.696) and those with pre-delivery SF ≥ 30 μg/L had a higher rate of recovery and a faster recovery time (hazard ratio: 10.77, P < .0001). This relationship remained stable after multivariate adjustment using linear regression analysis, and Kaplan-Meier plots of recovery of SF ≥ 30 μg/L during 280 days of gestation also showed significant differences between the 2 groups. In addition, In addition, the incidence of postpartum hemorrhage was significantly lower in the Group A (odds ratio: 0.374, 95% confidence interval: 0.155-0.901), and this association remained stable after adjusting for confounding factors by multivariate binary logistic regression analysis. Other pregnancy outcomes were not statistically significant. In plateau area, pregnant women with iron deficiency who start preventive iron supplementation with SF < 30 μg/L can reduce the incidence of iron deficiency and anemia before delivery compared with those who start preventive iron supplementation with Hb < 120 g/L, improve the level of Hb before delivery and the recovery rate and recovery time of SF ≥ 30 μg/L, and reduce the incidence of postpartum hemorrhage.