Pregnancy and Anemia

What is anemia?

Anemia is a decrease in red blood cells in the blood, which can lead to a lack of oxygen-carrying ability and causing unusual tiredness. The deficiency occurs either through the reduced production or an increased loss of red blood cells. Red blood cells are produced in the bone marrow, and their average life expectancy is about 120 days.

To produce red blood cells, the body needs (among other things) iron, vitamin B12 and folic acid. If there is a lack of one or more of these ingredients, anemia will develop.

Causes

• Poor intake of iron in diet. Iron is needed to make red blood cells. When women loose blood, they also loose iron. This happens in pregnancy due to the fact that the woman must supply iron to both herself and her baby. Iron is replaced by vitamin supplements or the diet.
• Folic acid deficiency. Folic acid is a Vitamin B, which is needed to produce red blood cells.
• Chronic illness
• Blood Loss from bleeding hemorrhoids or gastrointestinal bleeding
• Even if iron and folic acid intake are sufficient, a pregnant woman may become anemic because pregnancy alters the digestive process. The unborn child consumes some of the iron or folic acid normally available to the mother’s body.

Signs & Symptoms

The symptoms such as tiredness and general weakness will be similar to those of any other type of anemia. In severe cases, the woman will be short of breath even at rest.

If the anemia is prolonged, other signs of iron-deficiency anemia may develop such as a smooth shiny tongue and tenderness of the skin at the corners of the mouth. However, these advanced signs are rare.

Diagnoses

In the case of iron deficiency anemia, routine blood tests during antenatal care show low hemoglobin concentration as well as the characteristic small, pale red blood cells under the microscope.

The diagnosis of iron deficiency anemia can be confirmed by measuring the amount of storage iron as well as the levels of iron-binding proteins in the blood. The diagnosis of folate deficiency is confirmed by estimating the red blood cell folate levels.

Course of anemia

Patients with severe anemia are more likely to deliver early and have small babies. Women with severe anemia may have symptoms such as weakness, fatigue, shortness of breath and headaches.

Birth is also associated with blood loss. Therefore, if a woman is anemic, she should take iron for several months after delivery in order to help the body replace the lost blood cells and iron stores.

Breastfeeding women may also need to take iron because iron is lost in breast milk. As long as the anemia is treated and corrected, there should be no problems.

Management

A well-balanced diet is always recommended but iron and folate supplementation is indicated in pregnancy.

When the anemia is caused by lack of iron, it is treated with iron supplements, preferably ferrous sulfate tablets. These supplements should not be taken more than twice daily since the side effects of iron are increased in doses of more than two daily. The side effects are stomach upsets and constipation, which are problematic in pregnancy.

If the anemia is due to folic acid deficiency, it is treated with folic acid supplements.