Biobanking: IoT, safety challenges and security prospects.

Anemia represents a public health concern that affects approximately 25% of pregnant women in Europe, with iron deficiency (ID) being the predominant cause []. However, ID without anemia often goes undiagnosed and unmonitored in daily clinical practice due to the lack of complementary measures of iron status, such as determination of serum ferritin (SF), in addition to hemoglobin (Hb) []. In fact, SF is considered the most reliable indicator to estimate body iron levels, before anemia appears []. Depending on the SF cutoffs points used and the type of population, the percentage of pregnant women in Europe suffering from ID without anemia is also frequent (10–32%) []. In order to meet the increased iron needs of pregnancy and prevent the onset of anemia, systematic preventive iron supplementation for all pregnant women has long been proposed. However, this systematic iron supplementation may be excessive for some women. This is particularly important for those who have good iron stores at the beginning of pregnancy and/or carry the HFE gene mutation, which increases iron absorption in the intestine and is common in our population (43,4%) []. As a result of systematic preventive supplementation, a certain group of women may present iron excess during pregnancy []. In this regard, our research group found that approximately 24% of pregnant women with elevated Hb levels at the beginning of pregnancy presented a risk of hemoconcentration at the end of gestation []. Both iron deficiency anemia (IDA) and excess iron stores during pregnancy are common imbalances seemingly associated to adverse maternal and neonatal consequences, including reduced fetal growth [–]. On one hand, maternal anemia impairs placental development, and reduces oxygen and nutrient supply to the fetus [], while also weakening immune function and increasing infection risk, which all negatively affect fetal growth []. Conversely, excess maternal iron increases blood viscosity, disrupting uteroplacental blood flow and impairing fetal development []. This duality in iron status is supported by a recent systematic review, which confirms that the detrimental effect of maternal iron levels on offspring outcomes is U-shaped [].