Anemia in pregnancy: causes, risks, treatment and prevention

During pregnancy, the health of your growing baby depends on your own health. While this is an honor, it also places a great deal of stress on your body as nearly all body systems undergo changes. Cardiovascular physiology changes drastically during pregnancy, and these changes can contribute to anemia in pregnancy.¹ Knowing the causes, risks, treatment options and prevention strategies for pregnancy anemia can help you stay alert and help maintain the health of mother and baby.

Anemia is the reduced ability of the blood to transport oxygen.¹ This is due to a low number of red blood cells, a low level of hemoglobin in the red blood cells, or a low concentration of red blood cells in the blood plasma.² Hemoglobin is the protein in your red blood cells that binds oxygen and carries it to cells throughout your body.³ If the hemoglobin level falls below 10–11 grams per deciliter, depending on the trimester, pregnancy anemia can be diagnosed.^1.2

Pregnancy places increased demands on the mother’s body and blood, making her more susceptible to anemia. There are two main causes of anemia in pregnancy:^1.11

Blood volume increases during pregnancy, but plasma volume increases more than red blood cell count. Plasma volume increases by almost 50%, but red blood cell count increases by only about 18%. Because of this, hemoglobin concentration in the blood decreases due to dilution, resulting in a relatively low red blood cell count during pregnancy.^1.11 Hematocrit is the concentration of red blood cells in relation to the total blood volume. Therefore, a relatively low hematocrit value is normal during pregnancy.^3.11 This is called physiological anemia, which can be considered normal and potentially beneficial during pregnancy. Slightly thinner blood due to a lower concentration of red blood cells can facilitate blood flow to the uterus and placenta.^1.11

After dilution, iron deficiency during pregnancy is the main cause of pregnancy anemia.² During pregnancy there is an increased need for nutrients, especially iron, Folic acidand vitamin B12.^1.2 Many women not only need more of these nutrients than usual during pregnancy, but also do not consume enough of them, do not absorb the nutrients they do consume, and lose more nutrients than usual. For this reason, pregnant women are advised to take folic acid and iron supplements.¹

Types of anemia that affect pregnant and postpartum women

Pregnant women can be affected by many types of anemia, but the most common are iron deficiency anemia and folate deficiency megaloblastic anemia:^1.11

Iron deficiency is the cause of 75% of anemia cases diagnosed during pregnancy.¹ Iron is a building block of hemoglobin, the part of red blood cells that carries oxygen and removes carbon dioxide. During pregnancy, there is an increased production of red blood cells to increase blood volume. If the increased iron needs are not met through diet and supplements, a pregnant woman can develop iron deficiency and, as a result, anemia.⁴

Acute blood loss after childbirth is one of the main causes of anemia in pregnancy and the peripartum period. This is due to significant blood loss, which depletes the body’s iron stores and red blood cells. Postpartum hemorrhagedefined as blood loss of more than 1,000 milliliters within the first 24 hours after birth, is one of the main causes of this condition. It is often accompanied by signs and symptoms of hypovolemia, such as low blood pressure, rapid pulse, and dizziness, which further complicates the recovery process for new mothers. Effective treatment and timely intervention are crucial to prevent severe anemia and ensure the health of the mother.^11,12

During pregnancy, your baby uses up much of your supply of Folic acidand you absorb it more slowly, too. Folic acid is a B vitamin that helps produce red blood cells. Without enough folic acid, your body may produce too few red blood cells, which are very large, oval-shaped, and short-lived. This makes them less efficient at carrying oxygen throughout your body.⁵

Signs and symptoms

If your organs do not receive enough oxygen due to anemia during pregnancy, the following symptoms may occur:^1.2

• Headache
• Extreme fatigue
• Rapid breathing and heart rate
• paleness
• Cravings for ice cream or earth/clay during pregnancy
• Uncomfortable breathing
• Dizziness
• Exercise intolerance
• Depression and anxiety
• Brain fog and poor work performance

When I had anemia, I had every single one of these symptoms. It’s easy to dismiss them as normal parts of pregnancy. However, if you’re experiencing any of the symptoms above, your doctor may order a simple blood test to determine if anemia is present. A complete blood count is standard in the first trimester and again between 24 and 28 weeks pregnant, but you can request another at any time.²

Pregnancy places increased demands on your body and can be stressful, so a nutrient-rich diet is especially important. If these demands are particularly high or you do not meet them through intake, you may be at higher risk of developing anemia during pregnancy:^1.6

• Inadequate nutrition
• Lack of nutritional supplements
• Pregnancy with multiple births
• A small gap between pregnancies
• Teenage pregnancy
• Frequent vomiting due to Morning sickness
• History of anemia or heavy menstrual bleeding

Hemoglobin is made of iron. If you are wondering how to increase hemoglobin levels, your body needs to have enough iron. Many doctors recommend that all pregnant women prenatal vitamin with iron. If you suffer from iron deficiency, you may need a separate iron supplement during pregnancy:⁶

The CDC recommends that all pregnant women start taking iron supplements first prenatal visit.¹³ A pregnant woman with iron deficiency anemia should take 30–60 milligrams of iron three to four times a day, for a total of 200–300 milligrams per day.¹ What supports iron absorption is vitamin C, which promotes the absorption of iron from food and supplements. calcium hinders iron absorption. It is therefore best to take your iron supplement with oranges, tomatoes or strawberries and at the same time avoid dairy products or calcium-fortified orange juice.⁶

Iron supplements can cause gastrointestinal side effects such as nausea, vomiting, diarrhea, and constipation. Slow-release iron capsules or liquid iron can reduce these side effects and make it easier for a pregnant woman to continue taking iron supplements.¹

If an oral iron supplement is not tolerated or does not work, your doctor may consider an iron infusion during pregnancy. Iron infusions can deliver iron directly into the blood faster than supplements; however, your body still needs the same amount of time to turn the iron into red blood cells. While iron infusions avoid the gastrointestinal side effects of oral supplements, there is a risk of a reaction to the infusion, from allergic reactions to fever and skin discoloration.¹

Yes, iron deficiency anemia is associated with low birth weight, preterm birth and perinatal mortality.¹¹ Maternal iron deficiency during pregnancy is also associated with behavioral and brain development problems in children.² In addition to the risks of anemia for the baby, it also has consequences for the mother. Anemia during pregnancy can increase the likelihood of a cesarean section, postpartum anemia, blood transfusion during delivery, and even anemia. postpartum depression.^2.6

Sometimes anemia is unavoidable due to normal blood changes during pregnancy or physiological anemia.¹ However, a good diet is the best way to prevent severe anemia in pregnancy. Make sure you get enough iron and take supplements if needed.⁶

Dietary iron is most easily available to the body through animal protein sources that provide heme iron.⁷ These include lean red meat, poultry and Fish.⁶

Plant sources of iron are called non-heme iron. Non-heme iron is less easily absorbed but is not linked to colon cancer in the same way as heme iron.⁷ As for iron-rich vegetables, aim for dark green leafy vegetables, dried beans and peas, and nuts and seeds.^6.8 Finally, many breads and breakfast cereals are fortified with non-heme iron.⁶

Although no single food can cause or prevent anemia in pregnancy, there are some foods you should look for to optimize your absorption of dietary iron:^8th

Although dairy products are an excellent source of protein and a good choice during pregnancy, you should not consume dairy products at the same time as iron. Dairy products contain a high amount of calciumwhich hinders iron absorption. Therefore, it is best to leave at least an hour between consuming dairy products and iron.^8th

Found in CoffeeTea, beer and red wine can contain tannins that make it difficult for the body to absorb iron.^8th While you don’t need to eliminate these substances from your diet (although you probably don’t drink much beer and wine during pregnancy anyway!), it may be helpful to space out your consumption of iron-rich foods or iron supplements made from tannins.⁹

Phytic acid is found in grains, beans, nuts and seeds. This antinutrient binds to Minerals like iron, to make them inaccessible to the body. To significantly reduce phytic acid levels, you can soak your grains (such as rice or oats) in water overnight before draining, rinsing and cooking.¹⁰

Treating anemia of pregnancy requires attention and proactive measures for the health of both mother and baby. Expectant mothers can prevent and treat anemia by getting enough iron from their diet and supplementing when needed, treating underlying causes, and optimizing nutrient intake. Awareness of anemia symptoms and appropriate testing can facilitate diagnosis and treatment, so don’t be afraid to request a blood test if you feel unwell. With proper attention and care, you can minimize anemia in pregnancy and promote a healthy pregnancy and baby.