Anaemia is commonest medical disorder in pregnancy. 18-20% pregnant women are anaemic in developed countries as compared to 40-75% in developing countries. It is responsible (directly/contributory factor) for significantly high maternal and foetal morbidity and mortality throughout the world, but more so in developing nations.
As per WHO, Haemoglobin (Hb) level < 11gm/dl during pregnancy is diagnosed as anaemia.
Iron deficiency is by far the most common cause of anaemia in pregnancy, but it’s not the only cause. Pregnancy places major demands on the body because you must meet the needs of both your body and your growing baby. Your iron requirements go up significantly when you’re pregnant. Iron is essential for making haemoglobin, the protein in red blood cells that carries oxygen to other cells. Unfortunately, most women start pregnancy without
sufficient stores of iron to meet their body’s increased demands, particularly in the second and third trimesters. If you get to the point where you no longer have enough iron to make the haemoglobin you need, you become anaemic. For vegetarians dried beans and dark green leafy vegetables including spinach are especially good sources of iron and others are raisin bran (enriched), Instant oatmeal, beans (kidney, lima, Navy) , tofu, lentils, molasses, whole wheat bread, peanut butter, brown rice. The following foods are good sources of haem iron (from animal sources): Chicken liver, Oysters, Clams, Beef liver, Beef (chuck roast, lean ground beef), Turkey leg, Tuna, Eggs, Shrimp, Leg of lamb.
Other causes of anaemia include not getting enough folic acid or vitamin B12, by losing a lot of blood, or from certain diseases or inherited blood disorders such as sickle cell disease and
When anaemia is of mild to moderate degree and there is plenty of time (>30days) before expected date of delivery, oral iron therapy with 200mg elemental iron with 5mg folic acid per day will improve the haemoglobin by 0.8gm in a week. There is no advantage in using parenteral iron over oral iron, if oral iron is tolerated and there is plenty of time available.
In moderate anaemia (Hb 5 to <8), pregnancy near term (32-34wks), or if oral iron is not tolerated, parenteral iron therapy should be considered.
In severe anaemia (Hb < 5) blood transfusion is required.
Your baby does a good job taking care of his iron needs – he’ll get his share before you do. Still, maternal anaemia can affect a baby’s iron stores at birth, increasing his risk for anaemia later in infancy. Iron-deficiency anaemia during pregnancy is linked to an increased risk of preterm delivery and low birth weight. It’s also associated with a higher risk of stillbirth or newborn death, so it’s something to take seriously. Iron-deficiency anaemia affects your health as well. It can lower your energy and make it harder for your body to fight infection. And if you’re anaemic later in pregnancy, you’re more likely to have problems if you lose a lot of blood when you give birth. You may feel dizzy, have a rapid heart rate, or have other symptoms that require you to stay in the hospital an extra day or two. You’re also more likely to need a blood transfusion.
Take your prenatal vitamin and eat a healthy diet that includes plenty of iron-rich foods. Red meat is preferred, although poultry (dark meat) and other meats are good sources, too. Non-animal iron-rich foods include beans, lentils, raisins, dates, prunes, figs, apricots, potatoes (leave the skin on), broccoli, beets, leafy green vegetables, whole grain breads, nuts and seeds, oatmeal, and iron-fortified cereals. Keep in mind that your body absorbs the iron from animal sources much more readily than the iron from non-animal sources. Eating or drinking something rich in vitamin C when you take your iron supplement or eat iron-rich plant foods can help your body absorb significantly more iron. Good vitamin C choices include a glass of orange or tomato juice, a handful of strawberries, sliced bell peppers, or half a grapefruit.
For further information please consult our Expert:
Dr Divya Awasthi
MBBS, MS (OBG), DNB (OBG), MNAMS, FICMCH
Ex AIIMS, New Delhi
Ex Tata Cancer Hospital, Mumbai
Consultant Gynaecologist Max hospital, Mohali.