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Iron disorders, particularly iron deficiency anaemia, are prevalent in women of reproductive age and represent the leading cause of years lived with disability in women worldwide. During pregnancy, the prevalence of iron deficiency anaemia increases further (ranging from 12% to 80% depending on the region) and is associated with maternal morbidity and mortality, as well as adverse fetal and long\u2010term outcomes in offspring. Despite this burden, routine screening for iron deficiency is uncommon, and early treatment prior to the development of anaemia is lacking. Although far less prevalent, iron overload is also associated with adverse outcomes. Further studies are needed to elucidate the effects of maternal iron overload on the placenta and fetus, its consequences for child development, and to inform improved management strategies for this underrecognized condition. The goal of this review is to summarize physiological iron requirements and regulatory mechanisms during pregnancy, evaluate the benefits and limitations of available biomarkers and therapies, and underscore the importance of early and repeated screening for iron deficiency throughout gestation.<\/jats:p>","DOI":"10.1111\/bjh.70718","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T03:53:52Z","timestamp":1784951632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maternal iron homeostasis, disorders and pregnancy outcomes"],"prefix":"10.1111","author":[{"given":"Vida","family":"Zhang","sequence":"first","affiliation":[{"name":"Center for Iron Disorders, David Geffen School of Medicine University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-2397","authenticated-orcid":false,"given":"Elizabeta","family":"Nemeth","sequence":"additional","affiliation":[{"name":"Center for Iron Disorders, David Geffen School of Medicine University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7397-0815","authenticated-orcid":false,"given":"Veena","family":"Sangkhae","sequence":"additional","affiliation":[{"name":"Center for Iron Disorders, David Geffen School of Medicine University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(22)00084\u20105"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15270"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12645"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2020\u20100582"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.53260\/GREM.201043"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102011\u201004\u2010346304"},{"key":"e_1_2_11_8_1","volume-title":"WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations","author":"World Health Organization (WHO)","year":"2020"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","unstructured":"CantorA HolmesR BougatsosC AtchisonC DeLougheryT ChouR.Screening and supplementation for iron deficiency and iron deficiency anemia during pregnancy: systematic review to update the U.S. Preventive Services Task Force Recommendation.2024.","DOI":"10.1001\/jama.2024.13546"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.29151"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13870"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024013460"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7399.1124"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00008.2013"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010nutr\u2010061021\u2010030404"},{"key":"e_1_2_11_16_1","volume-title":"Dietary reference intakes for vitamin a, vitamin K, arsenic, boron, chromium copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc. 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