Iron Supplementation and Screening in Pregnancy

Rationale for Iron Supplementation and Other Interventions

The American College of Obstetricians and Gynecologists recommends against early glucose screening for women without risk factors for undiagnosed type 2 diabetes, such as history of GDM/pre-diabetes, previous macrosomia, obesity, metabolic syndrome, age >35 years, vascular disease, or high-risk ethnicity, as this patient does not have any of these risk factors 1
The American Heart Association states that proteinuria screening is not indicated in normotensive pregnant women without hypertension, as this patient's blood pressure is 110/70 mmHg, which is completely normal 2
The European Society of Cardiology recommends low-dose aspirin (75-100 mg/day) prophylactically only in women with history of early-onset preeclampsia (<28 weeks gestation), which this patient lacks 5
The American College of Cardiology is not directly mentioned, however, the European Heart Journal states that general prophylactic aspirin for all pregnant women is not recommended based on guideline evidence, and low-dose aspirin should be started before 16 weeks gestation in high-risk women 4, 5, 6

Preeclampsia is defined as gestational hypertension (≥140/90 mmHg developing after 20 weeks) plus significant proteinuria (≥0.3 g/day), and proteinuria assessment is performed when evaluating for preeclampsia, which requires hypertension as a prerequisite 2, 3
The American Heart Association recommends against proteinuria screening in normotensive pregnant women without hypertension, as it has no clinical utility for preeclampsia detection 2