Association between hematologic response to iron therapy and risk of stillbirth in pregnant singletons with moderate iron deficiency anemia.
Am J Obstet GynecolApr 30, 2026 (epub)
Clinical ResearchObstetrics & Gynecology
Rupsa C Boelig, Michael Georgieff, Simal Thind et al.
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In 30 seconds
This secondary analysis of a multicenter randomized controlled trial examined the association between hematologic response to iron therapy and stillbirth risk in 4252 pregnant women with moderate iron deficiency anemia. The study found that each unit increase in hemoglobin at 20 to 24 weeks significantly reduced stillbirth risk (relative risk, 0.74).
Key findings
- Each unit increase in hemoglobin response at 20 to 24 weeks was associated with a reduced risk of stillbirth (relative risk, 0.74).
- A significant quadratic relationship indicated increased stillbirth risk with hemoglobin levels decreasing below 10.5 g/dL (P<.0001).
- Early preterm birth risk at <34 weeks was also associated with decreasing hemoglobin levels (P=.01).
- The relative risk of small-for-gestational-age infants was not statistically significant despite a quadratic relationship (P=.008).
Why it matters
The findings underscore the importance of monitoring and improving hemoglobin levels in pregnant women with iron deficiency anemia, as inadequate response to iron therapy is linked to increased risks of stillbirth and early preterm birth.