Anemia and Pregnancy: Recognize it and treat it

Learn about the causes, symptoms, treatments, and possible consequences (for both mother and fetus) of anaemia during pregnancy, a condition that occurs in 40% of pregnancies.
Meat, eggs, fish, cereals and legumes are essential components of the pregnant woman’s diet. They are rich in iron, a mineral necessary for the synthesis of haemoglobin, the protein responsible for the transport of oxygen through the red blood cells.

During pregnancy, especially in the second and third trimesters, the need for iron in pregnant women increases to offset that used by the fetus. If the diet is not supplied in adequate amounts or the body’s reserves of this mineral were already low from the beginning, the future mother is at risk of anaemia due to lack of iron, a condition that manifests itself in 40% of pregnancies. In addition to weakening the body, anaemia can interfere with the oxygenation of the fetus. It is important to prevent it and, if it occurs, treat it intensively before the situation worsens.

Why Anaemia Occurs in Pregnancy

During pregnancy, the mother’s blood volume increases progressively to meet the metabolic needs of the woman and the unborn child. It is a physiological process called hemodilution: throughout pregnancy, it tends to decrease the blood concentration of the red blood cells and the haemoglobin they contain.

Under normal conditions, a woman with a haemoglobin concentration of less than 12 g / dl is considered anaemic. During pregnancy, the threshold is lowered and the diagnosis of anaemia occurs when the haemoglobin concentration is below 10 g / dl.

There are many reasons why a pregnant woman may be deficient in iron:

  • The hemodilution process added to the increased need for iron and poor diet.
  • Twin pregnancies increase the likelihood that women will become anaemic, because not one, but two or three children use their iron stores.
  • The presence of uterine fibroids that cause frequent small bleeding
  • A placenta previa responsible, also, for bleeding.

It is important to know the conditions of women during early pregnancy to monitor risk situations more closely. It is good for all pregnant women to undergo, as soon as they find out that they are expecting a baby, blood tests that check hematocrit, serum iron, ferritin, and transferrin values ​​to check for iron availability. the body.

During pregnancy, in the absence of specific risk factors, a woman is recommended to undergo a hematocrit between weeks 28 and 32 of pregnancy, and again between weeks 33 and 37. It is up to the gynaecologist, if he deems it appropriate, to prescribe other tests or a higher frequency.

Risks to Mother and Fetus

Fatigue, dizziness, headache, irritability, and shortness of breath are the characteristic symptoms of anaemia during pregnancy. Be careful not to underestimate them, because iron deficiency is not just a bothersome disorder for the pregnant woman. If neglected and aggravated, it can have serious consequences for the fetus. The shortage of this mineral and, therefore, of haemoglobin, can cause difficulties in the oxygenation of the fetus and a negative impact on its well-being and development. In addition, during labour, the mother will inevitably suffer a loss of blood (at best, about 200-300 cc of blood). If you reach the end of pregnancy with iron deficiencies, you will necessarily have to resort to blood transfusion.

When to Turn to Supplements

Under normal conditions, a varied and balanced diet is enough to assure the future mother of the iron she needs. Many foods, both animal and plant-based, are rich in iron:

  • Meat, especially red meat.
  • Eggs.
  • Fish (especially tuna, sardines and cod).
  • Cereals.
  • Pulses.
  • Green leafy vegetables.

In meat, eggs, and fish, iron is present in a chemical form that is easier for the body to process and about 25% of what is taken is absorbed. The absorption percentage of iron of vegetable origin is lower and variable but increases if accompanied by foods rich in vitamin C.

If anaemia is significant and is not a consequence of inadequate nutrition, for example, in the case of a pregnancy with twins, or anaemia prior to pregnancy, it is necessary to use iron supplements to supplement the diet.

Commercially, there is a wide selection of products that contain the mineral in various chemical forms. The most suitable, due to the easier assimilation, is the trivalent form. Some supplements also contain vitamin C to facilitate the absorption of iron. Supplements should be taken on an empty stomach, between meals. Sometimes they can cause bothersome side effects: heartburn, heaviness, and constipation, or conversely, frequent bowel movements. In these cases, it is convenient to take them on a full stomach to lessen the disturbances, although this reduces absorption.

Folic Acid Benefits

Along with iron, an essential chemical element for the synthesis of haemoglobin and, therefore, for the production of red blood cells, another micronutrient involved in the process of hematopoiesis, that is, in the production of blood, is the folic acid or vitamin B9.

All women who try it and pregnant women are advised to take a daily dose of 0.4 mg of folic acid at least from one month before pregnancy until the first trimester of waiting since a deficiency of this vitamin during the first few weeks of pregnancy greatly increases the risk of developing serious neural tube defects such as spina bifida. As an added benefit, supplementing folic acid before conception and during the first three months of pregnancy counteracts anaemia during pregnancy.

There is a form of anaemia caused specifically by folic acid deficiency, megaloblastic anaemia. It is characterized by the presence of a few larger than normal red blood cells and is quite rare: it represents only 0.5% of anaemia cases during pregnancy. It is diagnosed with a specific blood test, the globular volume test. Pregnant women suffering from megaloblastic anaemia are not only recommended to take a vitamin B9 supplement during the first trimester, but throughout the pregnancy.

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