Evaluation of an iron specific checklist for the assessment of dietary iron intake in pregnant and postpartum women

Objective This study developed and validated an iron checklist for assessing dietary iron intake of pregnant and postpartum women. Methods The checklist included 65 food and drink items. Iron intake measured by the checklist was compared with a diet history interview by paired t test and by the Bland-Altman method in 54 pregnant women. We then used the checklist to prospectively assess iron intake in a separate group of women in late pregnancy (n = 179) and at 6 mo postpartum (n = 177). The ability of the checklist to predict iron status was evaluated. Results There was no difference in reported mean iron intakes between the checklist and the diet history and there were good correlations between iron intake estimated from both methods (r = 0.69, P < 0.001 for food alone, r = 0.99, P < 0.001 for food plus supplements). However, the agreement between the two methods at an individual level was low. Pregnant women with low iron intake (lower than the recommended dietary intake) had lower serum ferritin levels (9.7 versus 14.5 μg/L, P < 0.001) and higher risk of iron deficiency (67.5% versus 34.9%, P < 0.0001) compared with women with adequate iron intake (at least the minimum recommended dietary intake), but these differences disappeared when women taking iron supplements were excluded. There was no association between iron intake and serum ferritin at 6 mo postpartum or between iron intake and hemoglobin levels at the end of pregnancy or at 6 mo postpartum. Conclusion This simple iron checklist is a useful tool in describing iron intake of population samples of pregnant women but has limited ability to predict iron status.