Dietary Iron Intake in Pregnant Women in Europe: A Review of 24 Studies from 14 Countries in the Period 1991–2014

Table 1

Dietary iron intake in pregnant women in European countries.

Country (city or region)	Study period	Women (n)	Age (years) mean ± SD and/or range	Trimester	Dietary method	Dietary iron mg/day			Recommended iron intake at time of study mg/day	Iron intake below recommended % of women	Reference
						Mean ± SD^2	Median	IQ^3 range, CI^4, percentiles^5
Bosnia (Canton Una Sana)	∼2014	∼40	25.6 ± 1.7	Not stated	24-hour recall	8.6			RDA 27	100% had intake <RDA	[16]
Croatia (Osijek)	2010–2011	222	Not stated	1st	24-hour recall		9.5	7.5–12.4^3	DRI 27	100% had intake <DRI	[17]
Croatia (Osijek)	2010–2011	222	Not stated	2nd	24-hour recall		10.1	7.8–13.3^3	DRI 27	100% had intake <DRI	[17]
Croatia (Osijek)	2010–2011	222	Not stated	3rd	24-hour recall		11.2	8.7–14.6	DRI 27	100% had intake <DRI	[17]
Czech Republic (Hradec Kralove Region)	2009–2010	152	28.9 ± 3.6	1st	7-day food diary	14.0 ± 3.5			RDA 27	52% had intake <RDA	[18]
Czech Republic (Hradec Kralove Region)	2009–2010	152	∼28.9 ± 3.6	2nd	7-day food diary	15.3 ± 3.5			RDA 27	57% had intake <RDA	[18]
Czech Republic (Hradec Kralove Region)	2009–2010	152	∼28.9 ± 3.6	3rd	7-day food diary	16.3 ± 3.5			RDA 27	60% had intake <RDA	[18]
Finland (Oulu)	1995–1996	113	29.6 ± 5.1	3rd	FFQ^1	16.5 ± 4.5			RDA 15^7		[19]
Finland (Oulu)	1995–1996	113	29.6 ± 5.1	3rd	5-day food diary × 2	12 ± 4			RDA 15^7		[19]
Finland (Oulu)	1995–1996	118	29.6 ± 5.1	3rd	5-day food diary × 2		11.4	9.6–12.9^3	RDA 15^7		[20]
Finland (Oulu & Tampere)	1998–1999	797	29.6 ± 5.1	1st & 2nd & 3rd	FFQ^1	18 ± 6			RDA 15^7		[21]
Germany (Hamburg)	2011–2013	200 (95% caucasian)	31 ± 3.5	1st	24-hour recall	12 ± 4			RDA 30	100% had intake <RDA	[22]
Germany (Hamburg)	2011–2013	200 (95% caucasian)	∼31 ± 3.5	2nd	24-hour recall	13 ± 3			RDA 30	100% had intake <RDA	[22]
Germany (Hamburg)	2011–2013	200 (95% caucasian)	∼31 ± 3.5	3rd	24-hour recall	12 ± 3			RDA 30	100% had intake <RDA	[22]
Germany (Hamburg)	2011–2013	200 (95% caucasian)	∼31 ± 3.5	1st & 2nd & 3rd	24-hour recall	12 ± 2			RDA 30	100% had intake <RDA	[22]
Greece (Pireus)	2003	98	18–40	2nd	FFQ	11.6 ± 5.0		10.6–12.6^4	DRI 30 (27)^see text	100% had intake <DRI	[23]
Greece (Pireus)	2003	102	18–40	3rd	FFQ	11.9 ± 4.9		11.0–12.9^4	DRI 30 (27)^see text	100% had intake <DRI	[23]
Greece (Athens)	2012	56	18–42	1st & 2nd	24-hour recall × 3	∼15.4 ± 6.4			DRI 27	98% had intake <DRI	[24]
Hungary (Budapest)	1990–1994	70	22.9 ± 4.4 (19–38)	1st, 2nd & 3rd	FFQ	11.3 ± 4.1			RDA 20	81% had intake <70% of RDA	[25]
Ireland (Dublin)	2013	402	30.8 ± 5.2	1st	FFQ	19.3 ± 10.3	17.0		RDA 14	37% had intake <RDA	[26]
Norway (Nationwide MoBa study)	2002–2005	7,455 nonsupplement users	29.2 ± 4.8	2nd	FFQ	10.8 ± 3.4	10.3	6.1–17.1^5	RDA 15^7		[27]
Norway (Nationwide MoBa Study)	2002–2005	32,653 supplement users	29.2 ± 4.8	2nd	FFQ	11.3 ± 3.4	10.9	6.6–17.6^5	RDA 15^7		[27]
Norway (Oslo Region)	2003–2004	119	31.2 ± 4.1 (23–44)	2nd	FFQ		11	7–19^5	RDA 15^7		[28]
Norway (Oslo Region)	2003–2004	119	31.2 ± 4.1 (23–44)	2nd	4-day weighed food diary		10	7–15^5	RDA 15^7		[28]
Poland (Nationwide)	2009	512	20–35	3rd	7-day food diary	10.1			RDA 24	∼100% had intake <RDA	[29]
Portugal (Porto)	2004–2005	249	29.2 ± 6.6 (18–40)	3rd	FFQ		16.0	12.5–19.2^3	AR 22	88% had intake <AR	[30]
Portugal (Porto)	2004–2005	70	∼29.8 ± 4.9	3rd	FFQ × 2	16.2 ± 5.5					[31]
Portugal (Porto)	2004–2005	101	29.8 ± 4.9	1st	3-day food diary	14.4 ± 4.8					[31]
Portugal (Porto)	2004–2005	101	∼29.8 ± 4.9	2nd	3 days food diary	14.3 ± 4.9					[31]
Portugal (Porto)	2004–2005	101	∼29.8 ± 4.9	3rd	3-day food diary	14.3 ± 5.0					[31]
Portugal (Porto)	2004–2005	101	∼29.8 ± 4.9	1st & 2nd & 3rd	3-day food diary	14.4 ± 3.7					[31]
Spain (Reus)	1991–1995	80	24–35	Preconception ≤12 weeks	7-day food diary	8.3 ± 3.0			RDA 18	∼98% had intake <RDA	[32]
Spain (Reus)	1991–1995	80	24–35	1st	7-day food diary	∼8.1 ± 2.1			RDA 18	∼98% had intake <RDA	[32]
Spain (Reus)	1991–1995	80	24–35	3rd	7-day food diary	∼8.5 ± 2.8			RDA 18	∼98% had intake <RDA	[32]
Spain (Reus)	1991–1995	80	24–35	Postpartum 6 weeks	7-day food diary	8.2 ± 2.3			RDA 18	∼98% had intake <RDA	[32]
Spain (INMA-Valencia)	2004–2005	822	∼17–40	1st	FFQ	20.7 ± 3.4	20.4	15.6–27.0^5	AR 22 DRI 27	68% had intake <DRI	[33]
Sweden (Umeå)^∗	2006–2009	209	23–40	1st	FFQ	∼13.1		∼12.5–13.8^4	RDA 15^7	98% had intake <RDA	[34]
UK (south West England) (ALSPAC)	1991–1992	11,923	27.9 ± 5.0 (15–44)	3rd	FFQ	10.4 ± 3.3	10.2	5.4–16.2^5	RNI 14.8	∼75% had intake <RNI	[35]
UK (Southampton)	1991–1992	569 caucasians	26.4 ± 4.8	1st	FFQ		15.0	12.2–18.6^3	RNI 14.8		[36]
UK (Southampton)	1991–1992	569 causasians	26.4 ± 4.8	1st	4-day food diary		10.1	7.9–12.4^3	RNI 14.8		[36]
UK (London)	2002	42 caucasians	33.2 ± 4.6 (19–40)	1st	4–7 day weighed food diary	12.3 ± 4.6			RNI 14.8	71% had intake <RNI	[37]
UK (London)	2002	42 caucasians	∼33.2 ± 4.6 (19–40)	2nd	4–7 day weighed food diary	12.1 ± 3.5			RNI 14.8	79% had intake <RNI	[37]
UK (London)	2002	42 caucasians	∼33.2 ± 4.6 (19–40)	3rd	4–7 day weighed food diary	13.0 ± 5.3			RNI 14.8	67% had intake <RNI	[37]
UK (London)	2002	42 caucasians	∼33.2 ± 4.6 (19–40)	Postpartum	4–7 day weighed food diary	12.3 ± 4.5			RNI 14.8	81% had intake <RNI	[37]
UK (Sheffield)	2003–2004	123 caucasians	29 ± 6.4 (17–43)	1st	FFQ	11.2 ± 3.9		4.7–21.1^6	RNI 14.8		[38]
UK (Sheffield)	2003–2004	123 caucasians	29 ± 6.4 (17–43)	1st	24-hour recall × 2	8.0 ± 2.8		2.6–17.8^6	RNI 14.8		[38]
UK (Leeds)	2003–2006	1,257	18–45	1st	24-hour recall	11.5 ± 5.3			RNI 14.8	80% had intake <RNI	[39]

¹FFQ = Food Frequency Questionnaire; ²SD = standard deviation; ³IQ range = interquartile range, 25–75 percentiles; ⁴CI = 95% confidence interval; ⁵5–95 percentile range; ⁶observed range; ⁷RDA for women of reproductive age. No specific recommendation for pregnant women; they are recommended oral iron supplements. AR = Estimated Average Requirement; daily intake levels estimated to meet the needs of half of the healthy pregnant women. DRI = Dietary Reference Intake; nutrition recommendations from the Institute of Medicine of the National Academies (USA). RDA = Recommended Dietary Allowance; daily intake adequate to meet the nutrient requirements of nearly all (97%–98%) healthy pregnant women. RNI = Reference Nutrient Intake; daily intake adequate to meet the nutrient requirements of nearly all (97.5%) healthy pregnant women.