Anemia in Pregnancy: Causes, Symptoms, and Treatment
Dr. Kamela Khalid
Mosque road, Bengaluru Feb 12, 2017
During pregnancy, your body produces more blood to support the growth of your baby. If you're not getting enough iron or certain other nutrients, your body might not be able to produce the amount of red blood cells it needs to make this additional blood.
It's normal to have mild anemia when you are pregnant. But you may have more severe anemia from low iron or vitamin levels or from other reasons.
Anemia can leave you feeling tired and weak. If it is severe but goes untreated, it can increase your risk of serious complications like preterm delivery.
Here's what you need to know about the causes, symptoms, and treatment of anemia during pregnancy.
TYPES OF ANEMIA THAT CAN AFFECT WOMEN DURING PREGNANCY
You could develop several types of anemia during pregnancy, including:
Iron deficiency: This type of anemia usually occurs when the body is not getting sufficient iron in order to produce satisfactory amounts of hemoglobin. This is a protein in the red blood cells and it transports oxygen out of the lungs to the other areas of the body. If you have an iron-deficiency anemia, enough oxygen will not be transported by the blood to the tissues throughout your body. This deficiency is found mostly during the final three months of pregnancy. At this time, the baby will require the red blood cells from your blood for continued development. You will become anemic if you are not consuming enough foods which have iron to restore the red blood cells that you have lost.
Folate deficiency: Folate is called ‘folic acid’ as well and it’s a type of B-vitamin. It is vital in order for you to have a healthy baby so your body needs extra amounts during pregnancy to produce brand-new cells which include healthy red blood cells. If you are not getting enough from your diet, your body won’t make enough of the normal red blood cells to carry oxygen to the tissues. This deficiency can contribute directly to certain forms of birth defects including low birth weight and spina bifida or neural tube abnormalities.
Vitamin B12 deficiency: During pregnancy, your body needs this vitamin to create healthy red blood cells. You will have a higher risk of developing this deficiency if you are vegetarian or if you don’t eat poultry, meat, eggs and dairy products. This might lead to birth defects like neural tube abnormalities and preterm labor.
It is important to mention that every pregnant woman will be at risk for having anemia because they require more folic acid and iron than normal. However, you will have a higher risk if you had two pregnancies near to each other, are pregnant with more than one child, are a teenager, are vomiting a lot due to morning sickness, had anemia prior to becoming pregnant or you are not eating enough iron rich foods.
While in most cases anemia is caused by not having enough iron in your diet before and/or during your pregnancy, less commonly it could be caused by a vitamin deficiency (B12 or folic acid), blood loss, an underlying condition like kidney disease, an immune disorder or sickle cellanemia — which is why it's so ...
Risk Factors for Anemia in Pregnancy
All pregnant women are at risk for becoming anemic. That's because they need more iron and folic acid than usual. But the risk is higher if you:
Are pregnant with multiples (more than one child)Have had two pregnancies close togetherVomit a lot because of morning sickness Are a pregnant teenagerDon't eat enough foods that are rich in ironHad anemia before you became pregnant
Symptoms of Anemia During Pregnancy
The most common symptoms of anemia during pregnancy are:
In the early stages of anemia, you may not have obvious symptoms. And many of the symptoms are ones that you might have while pregnant even if you're not anemic. So be sure to get routine blood tests to check for anemia at your prenatal appointments.
Risks of Anemia in Pregnancy
Severe or untreated iron-deficiency anemia during pregnancy can increase your risk of having:
A preterm or low-birth-weight babyA blood transfusion (if you lose a significant amount of blood during delivery) Postpartum depression A baby with anemiaA child with developmental delays
Untreated folate deficiency can increase your risk of having a:
Untreated vitamin B12 deficiency can also raise your risk of having a baby with neural tube defects.
Tests for Anemia
During your first prenatal appointment, you'll get a blood test so your doctor can check whether you have anemia. Blood tests typically include:
Hemoglobin test. It measures the amount of hemoglobin -- an iron-rich protein in red blood cells that carries oxygen from the lungs to tissues in the body.Hematocrit test. It measures the percentage of red blood cells in a sample of blood.
If you have lower than normal levels of hemoglobin or hematocrit, you may have iron-deficiency anemia. Your doctor may check other blood tests to determine if you have iron deficiency or another cause for your anemia.
Even if you don't have anemia at the beginning of your pregnancy, your doctor will most likely recommend that you get another blood test to check for anemia in your second or third trimester.
Treatment for Anemia
If you are anemic during your pregnancy, you may need to start taking an iron supplement and/or folic acid supplement in addition to your prenatal vitamins. Your doctor may also suggest that you add more foods that are high in iron and folic acid to your diet.
In addition, you'll be asked to return for another blood test after a specific period of time so your doctor can check that your hemoglobin and hematocrit levels are improving.
To treat vitamin B12 deficiency, your doctor may recommend that you take a vitamin B12 supplement.
The doctor may also recommend that you include more animal foods in your diet, such as:
Your OB may refer you to a hematologist, a doctor who specializes in anemia/ blood issues. These specialist may see you throughout the pregnancy and help your OB manage the anemia.
To prevent anemia during pregnancy, make sure you get enough iron. Eat well-balanced meals and add more foods that are high in iron to your diet.
Aim for at least three servings a day of iron-rich foods, such as:
lean red meat, poultry, and fish leafy, dark green vegetables (such as spinach, broccoli, and kale) iron-enriched cereals and grains beans, lentils, and tofu nuts and seeds eggs
Foods that are high in vitamin C can help your body absorb more iron. These include:
citrus fruits and juices strawberries kiwis tomatoes bell peppers
Try eating those foods at the same time that you eat iron-rich foods. For example, you could drink a glass of orange juice and eat an iron-fortified cereal for breakfast.
Also, choose foods that are high in folate to help prevent folate deficiency. These include:
leafy green vegetablescitrus fruits and juicesdried beansbreads and cereals fortified with folic acid
Follow your doctor's instructions for taking a prenatal vitamin that contains a sufficient amount of iron and folic acid.
Vegetarians and vegans should talk with their doctor about whether they should take a vitamin B12 supplement when they're pregnant andbreast feeding.