Evaluation and treatment of anemia in pregnancy

Iron deficiency is common in pregnancy and is associated with adverse maternal and fetal outcomes, although causation has not been demonstrated. Oral iron takes weeks to months to replete iron stores, depending on the degree of deficiency; this is unlikely to be effective beyond 30 weeks gestation. IV iron repletes stores much more rapidly; some individuals may reasonably choose to use oral iron if they have reasons to avoid IV iron. Transfusion is reserved for severe, symptomatic anemia (Hb <7 g/dL or acute anemia with hemodynamic or respiratory compromise).