[Anemia in pregnancy--review. Part 2].

Objective: To review the clinical risks of iron deficiency anemia (IDA) in pregnant women: a list of the possible disorders of the mother, fetus and the newborn. A discussion about the clinical value of iron administration in gestation.

Design: Review article.

Setting: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. Apolinárská 18, Prague 2, 128,00.

Methods: Analysis of the results in literature (texts in medical journals, monographies, textbooks, internet--"Medline") and authors' clinical experience.

Conclusions: Routine iron supplementation in pregnancy is still a controversial issue. The key question is, whether improving the mother's laboratory parameters helps to improve her clinical status and the clinical outcome of pregnancy. There is no doubt that iron supplementation in pregnancy decreases the incidence of anemia and increases the level of iron stores in the 2nd and 3rd trimester of gestation as well as in the puerperium. Even with the presence of many recent studies there still exists a lack of proper evidence, that routine iron administration in pregnancy leads to improvement of the clinical status of the mother and fetus. Up to this time there is not sufficient proof either in favour of or against iron supplementation in pregnancy. In conclusion, there is a need for further research (randomized, controlled, clinical trials focused on the clinical outcomes of pregnancy, with a sufficient amount of pregnant women and with representative statistical evaluation; or careful metaanalysis of the existing studies) to reach definite results about the importance of iron administration and about the treatment of asymptomatic anemia in gestation.