Assessment of iron status in US pregnant women from the National Health and Nutrition Examination Survey (NHANES), 1999-2006

Background: Total body iron calculated from serum ferritin and soluble transferrin receptor concentrations allows for the evaluation of the full range of iron status. Objective: We described the distribution of total body iron and the prevalence of iron deficiency (ID) on the basis of total body iron in US pregnant women. Design: We examined data from the National Health and Nutrition Examination Survey (NHANES) in 1999-2006 for 1171 pregnant women. Results: ID prevalence (+/- SE) in US pregnant women, which was defined as total body iron <0 mg/kg, was 18.0 +/- 1.4%. Pregnant women in the first trimester had a higher mean total body iron than did pregnant women in the second or third trimesters. ID prevalence in pregnant women increased significantly with each trimester (6.9 +/- 2.2%, 14.3 +/- 2.1%, and 29.5 +/- 2.7% in the first, second, and third trimesters, respectively). Pregnant women with parity >= 2 had the lowest mean total body iron and the highest prevalence of ID compared with values for pregnant women with parity of 0 or 1. The ID prevalence in non-Hispanic white pregnant women was significantly lower than in Mexican American or non-Hispanic black pregnant women. The mean total body iron and the prevalence of ID did not differ by educational level or by family income. Conclusions: To our knowledge, these are the first data on total body iron distributions for a representative sample of US pregnant women. Low total body iron is more prevalent in pregnant women in the second or third trimesters, in Mexican American pregnant women, in non-Hispanic black pregnant women, and in women with parity >= 2. Am J Clin Nutr 2011;93:1312-20.