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Anemia and Pregnancy

  • Chris Woolston, M.S.
  • Posted March 11, 2013

It takes strong building materials to make a healthy baby, and few things are stronger than iron. Iron forms the core of red blood cells, the vehicles that carry oxygen to every part of your body, including to your growing baby. If you don't have enough iron -- a common problem in pregnancy -- these vehicles will start to break down, leaving you and your baby deprived of oxygen.

This condition, called iron-deficiency anemia, can be dangerous to your pregnancy, especially if it occurs in the first or second trimester. As reported in the American Journal of Clinical Nutrition, iron-deficiency anemia early in a pregnancy can double or even triple the risk of having a premature delivery or a low birth weight baby.

And if you're anemic during pregnancy, there's a good chance your baby will be anemic too, which might slow his growth and development after he's born.

As you prepare for the big day, you should watch for signs of anemia while taking steps to prevent it.

What are the symptoms of iron-deficiency anemia?

If you only have a small shortfall of iron, you may not notice any symptoms at all. But as iron supplies get lower and lower, the signs of anemia become clearer. You may feel unusually tired and weak. You might also be irritable and have trouble concentrating on your work.

The National Women's Health Information Center lists some signs and symptoms of iron-deficiency anemia that can develop when the anemia is more severe:

  • low body temperature
  • pale skin
  • shortness of breath
  • chest pain
  • dizziness
  • cold or numb hands and feet
  • rapid or irregular heartbeat

How is iron-deficiency anemia diagnosed?

A simple blood test can determine if you have enough iron for a healthy pregnancy. Your doctor should perform this test at your first prenatal visit and repeat it as needed.

How can iron-deficiency anemia be prevented?

The U.S. Department of Health and Human Services says pregnant women should get at least 27 milligrams of elemental iron every day, about 9 milligrams more than non-pregnant women need. In theory, you could meet that goal by loading up on iron-rich foods such as red meat, leafy greens, eggs, poultry, dried fruits, and iron-fortified cereal.

While these foods can be an important part of your diet, they probably won't be enough. The reality is that very few pregnant women get sufficient iron through diet alone. For this reason, many doctors and leading health institutions -- including the U.S. Department of Health and Human Services -- recommend iron supplements for all pregnant women.

Iron pills are sold over the counter, and iron is included in many prenatal vitamins. But don't start popping extra iron until you've talked to your doctor at your first prenatal appointment. Iron can cause an upset stomach, nausea, and constipation -- things that pregnant women certainly don't need. Your doctor can show you how to get enough iron without going overboard.

Most doctors recommend that pregnant women take prenatal vitamins, which likely contains all the iron you need. Be sure to let your doctor know about any multivitamins you take.

Fortunately, it may be possible to find a happy balance between too little iron and too much. A recent study published in the American Journal of Clinical Nutrition found that a low dose of iron (20 milligrams per day) may prevent iron-deficiency anemia during pregnancy without any significant side effects. If you are already anemic, you may need a higher dose of iron.

Preventing anemia is just one step toward a healthy pregnancy, but it's an important one. When you're making a baby, you can't skimp on the iron.

References

The National Women's Health Information Center. Frequently Asked Questions: Anemia. May 2008. http://www.womenshealth.gov/faq/anemia.cfm#3

Allen LH. Anemia and iron deficiency: effects on pregnancy outcome. American Journal of Clinical Nutrition, May 2000. 71 (suppl): 1280S-1284S.

Makrides M et al. Efficacy and tolerability of low-dose iron supplements during pregnancy: a randomized controlled trial. American Journal of Clinical Nutrition, July 2003. 78: 145-153.

Mayo Clinic. Iron Deficiency Anemia. http://www.mayoclinic.com

International Nutritional Anemia Consultative Group. Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia. http://www.ilsi.org/file/b2_VUHUQ8AK.pdf

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