Iron in Pregnancy and Anemia.

The recommended daily allowance (RDA) of iron during pregnancy is 27 mg. In a non pregnant woman, the RDA for iron is 18 mg. The need for iron in pregnancy increases by almost 50%. In pregnancy therefore, there lies a risk of iron deficiency  and development of anemia.  Care therefore, should be taken to have enough iron in your diet.

Why you require more Iron in pregnancy.

  • The red blood cells of the blood contain a protein called hemoglobin, a significant part of which is made of iron. This hemoglobin carries oxygen in the blood to be supplied to various parts of the body. Lack of iron therefore results in less oxygen being received by the body cells. The result is anemia.
  • Due to increase in blood volume and circulation during pregnancy by almost 50%, iron requirement increases to make that much more hemoglobin. Besides the increased need by the fetus, having extra iron by the pregnant mother also helps to combat blood lost during delivery. About two-thirds of iron in the body is stored in hemoglobin. It is important to fulfill this increased requirement in order to fuel increased production of hemoglobin and avoid  anemia.
  • Towards the end of pregnancy, the baby too starts storing a good six months’ requirement of iron as it does not get enough of it from the mother’s milk. After six months, solid foods (which are often fortified) begin the iron supply to the infant.
  • Iron also helps in development of muscles in the mother and baby.
  • Sufficient intake of iron also reduces risk of premature delivery and low birth weight baby.

Effects of Anemia on Pregnant Mother and Fetus.

Preventing an iron deficiency pregnancy is a must,  in lieu of the effects it can have on the mother and fetus.

  • Anemic mothers who have iron deficiency are at a greater risk of perinatal death, premature delivery and low birth weight babies.
  • Immunity of the anemic mother is also compromised.
  • Anemia also increases risks of fetal abnormalities, fetal deaths and long-lasting defects in mental development.
  • Iron deficiency in pregnant mothers also increases risk of severe morning sickness.

When is Testing for Iron done in Pregnancy.

Usually women are tested for iron levels in blood twice during the course of pregnancy. The first is during the beginning of pregnancy and then during the end of the second trimester or beginning of the third trimester (ie around the 28th week of pregnancy).

It is during the second half of pregnancy that there is a surge of formation of blood and plasma and the red blood cell formation may not keep up at the same pace. If anemia is detected at this period, retesting is done after about two weeks to allow the RBC to form and show the true levels of iron in blood.

What Risk Factors Make You Prone to Anemia.

  • If you have been dieting to lose weight
  • If your diet does not give you enough iron
  • If your pregnancies have been close to each other (less than 2 years)
  • If you have bled more during your periods

Signs and Symptoms of Iron Deficiency Anemia in Pregnancy.

Many a time you may not experience any symptoms though you are anemic. This may happen especially when your anemia is mild. The symptoms and signs when present can manifest as follows:

  • Your skin appears paler than usual. Paleness  is also seen in your fingernails, conjunctiva of the eyes and on your tongue.
  • You will feel tired, fatigued, weak and dizzy.
  • Feeling cold in your hands and feet
  • Frequent headaches and irritability
  • You will have trouble concentrating.
  • You will have palpitations (of the heart).
  • Shortness of breadth
  • Your doctor will notice a rapid heartbeat.

Treatment of Iron Deficiency Anemia.

Anemia is typically treated with iron supplements containing ferrous sulfate or ferrous gluconate or ferrous fumarate. The dose will depend on the severity of the anemia. Iron supplements are to be taken with water and not with tea, or coffee or milk. The calcium in milk interferes with iron absorption. Secondly do not exceed the dose advised by your doctor.

Stomach upset is often seen with iron supplements. In such cases, the tablets may be changed or dose lowered or  divided over the day or you may be advised to have the supplements after meals.

Within a week after starting iron supplements, your hemoglobin (Hb) levels will begin to rise and it may be two months for Hb levels to come to normal. Iron supplements are continued further for several months to replenish your iron reserves.

Stools may darken in color due to iron supplements and this is normal and harmless. But if you notice blood in stools, talk to your doctor.

Prevention of Anemia in Pregnancy.

It is always wise to prevent than to cure if you can help it. Anemia in pregnancy can be prevented by taking your prenatal supplements which your doctor has advised, religiously. Secondly follow your pregnancy diet also religiously. This is enough to keep anemia away.  Below are some foods that are rich sources of iron. Do incorporate them in your diet.

Iron Rich Foods for Pregnancy.

  • Beef
  • Pork
  • Shrimp.
  • Spinach and other green vegetables
  • Broccoli
  • Green beans
  • Tomato juice
  • Legumes
  • Dried fruits
  • Enriched and whole grains (wheat, rice, barley, conmeal).
  • Oatmeal
  • Potatoes
  • Raisins
  • Dates
  • Tofu (bean curd made by coagulating soy milk).
  • Jaggery.
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