During pregnancy, there is a higher demand for red blood cells to support the development of your growing baby. But when you have anemia, your body doesn’t have enough healthy red blood cells to carry oxygen to your tissues and to your baby.
In the condition where there’s a lack of oxygen supply, many organs and functions are affected and this is especially a medical concern for pregnant mommas for it is associated with low birth weight, premature birth, and maternal mortality.
Anemia in pregnancy is defined as a hemoglobin concentration of less than 110 g/L (less than 11 g/dL) in venous blood. There are over 400 different types of anemia, but some are more prevalent in pregnancy, such as:
Iron-deficiency anemia continues to be the most common type of anemia during pregnancy, contributing to about 95% of anemia cases related to pregnancy. This type of anemia typically occurs when the body doesn’t have enough iron to produce adequate amounts of hemoglobin.
Folate refers to folic acid, a water-soluble vitamin that can help prevent neural tube defects during pregnancy and is commonly taken as a supplement by pregnant women. It can also be found in fortified foods such as cereals, leafy vegetables, bananas, melons and legumes. A diet lacking folic acid leads to a reduced number of red blood cells in the body, thus causing deficiency.
Vitamin B12 is also one of the essential vitamins for our body to have to help with the production of red blood cells. Women who don’t eat meat, poultry, dairy products, and eggs have a greater risk of developing vitamin B12 deficiency.
Physiological adaptation in pregnancy leads to physiological anemia in pregnancy. Hemodilution often occurs where the plasma volume expansion is greater than red blood cell mass increment. Normal pregnancy increases iron requirement by 2-3 fold and folate requirement by 10-20 fold. Some of the major causes of anemia include:
Nutritional – iron, folate and vitamin B12 deficiencies
Acute or chronic blood loss (gastrointestinal bleeding/heavy periods)
Infections – malaria, HIV
Chronic diseases – renal, neoplasia
Hemolytic anemias – drugs, congenital
Hemoglobinopathies – sickle cell, thalassemia
Anemia during pregnancy can be a mild condition and easily treated if caught early on. However, it can become dangerous, to both the mother and the baby, if it goes untreated.
Anemia increases perinatal risks for mothers and neonates. It
Increases overall infant mortality,
Raises the risk of neural tube defects
Tripled the odds for fetal growth restriction and low birth weight, and
Doubled the odds of preterm delivery
A basic principle of fetal/neonatal iron biology is that iron is prioritized to red blood cells at the expense of other tissues, including the brain. When the iron demand exceeds the iron supply, the fetal brain may be at risk even if the infant is not anemic. It adversely affects cognitive performance, behavior and physical growth of infants, preschool and school-aged children. Immune status will be depressed, and morbidity from infections in all age groups will increase.
Preventing anemia during pregnancy is as easy as changing, or making additions, to your diet. Medical professionals recommend a pregnant woman eat 30mg (at least three servings) or iron each day.
You can read more about the best iron-rich foods and diet plans to prevent anemia here.
Pre-pregnancy counseling, dietary advice and therapy is very important for ensuring best pregnancy outcomes. It is recommended that full blood count should be checked at the booking visit in pregnancy and repeated at 28 weeks to screen for anemia.
In high-risk mothers and multiple pregnancies, an additional hemoglobin check should be performed near term. Dietary advice should be given to all mothers to improve the intake and absorption of iron from food.
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American Pregnancy Association. (2019). Anemia During Pregnancy: Causes, Symptoms & Treatment. [online] Available at: https://americanpregnancy.org/pregnancy-concerns/anemia-during-pregnancy/.
Johnson, T. (2018). Anemia in Pregnancy: Causes, Symptoms, and Treatment. [online] WebMD. Available at: https://www.webmd.com/baby/guide/anemia-in-pregnancy#2.
Talaulikar, V. (2019). Anemia in pregnancy. [online] Available at: https://www.glowm.com/Critical_current_issue/page/25.
Friel, L. (2019). Anemia in Pregnancy - Gynecology and Obstetrics - MSD Manual Professional Edition. [online] MSD Manual Professional Edition. Available at: https://www.msdmanuals.com/professional/gynecology-and-obstetrics/pregnancy-complicated-by-disease/anemia-in-pregnancy.
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