Anemia in Pregnancy

During pregnancy, it is extra important to ensure that you are getting the recommended daily intake of iron since your baby will be drawing from your iron reserves. A lack of sufficient iron from your diet can result in anemia, which can put both you and your baby at risk.

What is Anemia?
Anemia refers to a condition whereby your body lacks the appropriate amount of hemoglobin, or red blood cells. Red blood cells are an important part of the body’s blood system as they carry oxygen to other cells in your body. Having a shortage of these blood cells means that your body must work harder to get that oxygen to your organs and tissue. Due to the extra exertion, you’re likely to feel irritable and lethargic.

Iron’s Role in Anemia
Anemia can be caused by a variety of things. Some people may suffer from a genetic condition, like sickle cell anemia, that causes them to have anemia while others may develop anemia after experiencing severe blood loss. However, the most common form of anemia is due to vitamin or nutrient deficiency. Known as nutritional anemia, a lack of iron, folic acid, or vitamin B12 can result in a woman developing anemia. For most people with nutritional anemia, the culprit is iron.

Normally, the recommended daily intake of iron for an adult woman is 18mg per day. During pregnancy, though, this increases to 27mg per day due to the rise in maternal blood volume (about 50% more than your pre-pregnancy days). Additionally, your baby will be drawing from your iron stores in order to build up her own, which she will use during the first few months of her life.

Unfortunately, most women already have low iron stores prior to their pregnancy. Even if you eat a well-balanced diet while pregnant, it is still unlikely that you will get the recommend 27mg of iron a day since even the most nutritional diet only provides you with about 12mg to 14mg of iron. In order to avoid an iron deficiency, it is often necessary for pregnant women to take iron supplements. Luckily, the majority of prenatal vitamins contain 30mg of iron, so make sure you take your vitamins!

Are You at Risk?
In addition to having low iron stores, your risk for developing anemia during pregnancy increases if you:

  • Are suffering from frequent vomiting due to morning sickness
  • Have had two pregnancies close together
  • Are carrying twins or multiples
  • Had a heavy menstrual flow prior to pregnancy

Signs of Anemia
Many women do not realize that they have developed anemia. It is not unusual for women with a mild condition to fail to notice any outward symptoms of an iron deficiency. However, typical signs of anemia include:

  • Fatigue, dizziness, and weakness
  • A paler complexion, most notably in the lips, fingernails and underneath the eyelids
  • Shortness of breath
  • Difficulties concentrating
  • Heart palpitations
  • Rapid heartbeat

Severe iron deficiency has been linked in various studies to pica. If you find yourself craving odd things, like clay or dirt, make an appointment with your health care provider.

Determining if You Have an Iron Deficiency
Because so many women do have low iron stores, it is has become standard practice for to be evaluated for anemia at your first prenatal appointment. During this appointment, two blood tests will be done. The first, hematocrit, will measure the percentage of red blood cells in your system while the second, a hemoglobin test, will assess the number of grams of hemoglobin per 100 milliliter of blood. These tests will be performed again between the 24th and 28th week of your pregnancy, as it is more likely that a woman will develop anemia later in pregnancy.

Anemia Treatment
If you are found to have an iron deficiency, you will most likely be prescribed an iron supplement. However, these supplements will only help those experiencing anemia due to a lack of iron. Other causes of anemia will require different treatment.

Iron supplements can be prescribed in 60mg to 120mg doses. To help with the absorption of iron, it is recommended that the supplements be taken on an empty stomach and with a source of vitamin C, such as orange juice. Avoiding taking an iron supplement with calcium as this can inhibit iron absorption.

Irritation of the gastrointestinal tract is the most common side effect of iron supplements. Many women will experience constipation while taking the supplements (increase your fiber intake to help counteract this) but you may also suffer from diarrhea and nausea. If the nausea bothers you, try taking your supplement at bedtime and speak with your prenatal health care provider to see what else you can do for the nausea. One other side effect associated with these supplements: very dark stools. So don’t be alarmed if your stools appear black once you start with iron supplements.

Health Risks to You and Your Baby
Because you are likely to become anemic long before your baby, as his iron needs will be met before yours, the chances of your baby suffering health problems are fairly low. However, it is important to receive quick and proper treatment if you are found to be anemic as there are a variety of health problems that may arise without treatment.

Experiencing anemia during the first or second trimester increases your risk of preterm labor while your baby is more likely to be born with a low birth weight. Women who develop a severe iron deficiency increase their child’s risk of developing anemia during infancy. Furthermore, aside from making you feel exhausted and lowering your bodies ability to fight illness, developing anemia late in pregnancy may cause you some problems when you give birth, particularly if you end up losing a lot of blood. Anemia increases the chances you’ll need a blood transfusion and can produce symptoms that require you to stay in the hospital a bit longer after birth.

Getting Enough Iron
There are many iron rich foods that make up a healthy diet. Red meat is perhaps one of the best sources of iron but fish and poultry come in at a close second. For those of you who prefer to get your iron from non-meat sources, look to include tofu, eggs, leafy green vegetables, legumes, broccoli, whole-grain bread, iron-fortified cereals and dried fruit, like raisins, dates and apricots, in your diet.

It is important to remember, though, that your body more easily absorbs iron from meat sources than non-flesh sources. To help with iron absorption from non-flesh foods, have a glass of orange juice or eat another source of food that is high in Vitamin C along with your iron rich food.

One last piece of advice about iron: don’t get your iron from liver or liver products, such as pâté, while you are pregnant. Although liver is a fantastic source of iron, it is also high in vitamin A. Consuming too much vitamin A during pregnancy has been linked to birth defects. This is why many women are advised to steer clear of getting extra vitamin A while they are pregnant. However, it is also important to note that there are actually two forms of vitamin A: retinol and betacarotene. Betacarotene sources of vitamin A are thought to be safe during pregnancy while retinol is not.

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