The Critical Role of Iron in Pregnancy, Puerperium, and Fetal Development.

: Iron is a fundamental micronutrient. Its deficiency could have a potentially harmful influence on maternal and fetal well-being. : This review synthesizes current evidence on the epidemiology, consequences, and clinical meaning of iron deficiency (ID) and iron deficiency anemia (IDA) in pregnant women. : Untreated ID in pregnancy is associated with a wide spectrum of adverse outcomes: maternal clinical symptoms, cardiovascular disturbances, preterm birth, low birth weight, and impaired fetal neurodevelopment. Furthermore, ID has been related to impaired implantation, miscarriage, congenital heart defects, and neurological complications in fetuses. Women with gastrointestinal disorders and low socioeconomic status constitute a high-risk group of developing IDA. ID remains underdiagnosed and suboptimally managed in some clinical practices. : This review highlights the critical importance of early detection, individualized supplementation, and public health interventions aimed at reducing iron deficiency during pregnancy.