Universal iron supplementation in pregancy-Why not??

   Universal iron supplementation in pregancy-Why not??  Routine Fe suppl cause good to most preg women: But does routine supplementation in pregnancy can cause harm to the woman concerned?

This is a longstanding debate, particularly   in the industrialized    countries where most of the pregnant women are not anemic at initial few visits. They may decline to ingest Fe unnecessarily. Should it be universal or selective in our country? Can we do harm to a pregnant women by administering Fe to woman who is fee sufficient? The advantages of routine Fe suppl without assessing her Fe status.

Points in favour of routine suppl after 16 weeks are: - 1) Adequate foetal iron store particularly in the liver, is ensured, 2) routine Fe suppl might prevent adult hypertension, if foetus gets adequate quantum of iron supply throughout pregnancy. Foetal iron supply line, as we know is through maternal transferrin. This maternal transferrin level is not always related to maternal iron stores.  Th maternal transferrin which trapped by the placenta like iodine trapping by thyroid)àstore in gestational period 3) Additionally, if a preg women is sub clinically Fe deficient à  she may give birth to a neonate with poor Fe storeà who  may fail  catch up later as he/she grows up as child. Such children are often termed by the hematologist colleagues as “iron deficient in the absence of anemia “.Prevalence of such children is not uncommon in India. Such toddler may develop behavioral disorders, development of anemia in first few years of life as breast milk contain minimal Fe. Such children born with minimal Fe store in liver may later develop cognitive disorders.