Anemia in Pregnancy
Blood is the fluid that circulates through the body's heart, arteries, veins, and capillaries. It carries away waste matter and carbon dioxide, and brings nourishment, electrolytes, hormones, vitamins, antibodies, heat, and oxygen to the tissues.
What is anemia?
Anemia is a condition of too few red blood cells. This lowers the ability of your red blood cells to carry oxygen or iron. Chemicals in the body's tissues (enzymes) that are dependent on iron can affect cell function in nerves and muscles. Your baby is dependent on your blood. If you have anemia, your baby may not grow to a healthy weight, may come early (preterm birth), or have a low birthweight.
What are the most common types of anemias to occur during pregnancy?
You can get several kinds of anemias during pregnancy. These are:
Anemia of pregnancy. In pregnancy, a woman's body makes extra blood. This causes the concentration of red blood cells in her body to become diluted. This is sometimes called anemia of pregnancy and is not considered abnormal unless the levels fall too low.
Iron deficiency anemia. During pregnancy, your baby uses your red blood cells for growth and development, especially in the last three months of pregnancy. If you have extra red blood cells stored in your bone marrow before you get pregnant, you can use those stores during pregnancy to help meet your baby's needs. Women who do not have adequate iron stores can develop iron deficiency anemia. This is the most common type of anemia in pregnancy. It is the lack of iron in the blood, which is necessary to make hemoglobin--the part of blood that distributes oxygen from the lungs to tissues in the body. Good nutrition before becoming pregnant is important to help build up these stores and prevent iron deficiency anemia.
Vitamin B12 deficiency. Vitamin B12 is important in forming red blood cells and in protein synthesis. Eating food that comes from animals, such as milk, eggs, meats, and poultry, can prevent vitamin B12 deficiency. Women who don't eat any foods that come from animals (vegan) are most likely to get vitamin B12 deficiency. Strict vegans usually need to get vitamin B12 shots during pregnancy.
Folate deficiency. Folate, also called folic acid, is a B-vitamin that works with iron to help with cell growth. If you don't get enough folate during pregnancy, you could get iron deficiency since both folic acid and iron are found in the same types of foods. Research shows that folic acid may help reduce the risk of having a baby with certain birth defects of the brain and spinal cord if taken before conception and in early pregnancy.
What are the symptoms of anemia?
Women with anemia of pregnancy may not have obvious symptoms unless the cell counts are very low. Symptoms of anemia can be different for each woman. Symptoms may include:
Pale skin, lips, nails, palms of hands, or underside of the eyelids
Vertigo or dizziness
Rapid heartbeat (tachycardia)
The symptoms of anemia sometimes look like other conditions or medical problems. Always see your health care provider for a diagnosis.
How is anemia diagnosed?
Your health care provider will check for anemia during your prenatal examinations. It is usually found during a routine blood test for hemoglobin or hematocrit levels. Other way s to check for anemia may include additional blood tests and other evaluation procedures.
Treatment for anemia
your health care provider will figure out the best treatment for your anemia based on:
Your overall health and medical history
How sick you are
How well you can handle specific medications, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
Treatment depends on the type of anemia and how bad it is. Treatment for iron deficiency anemia includes iron supplements. Some forms are time-released, while others must be taken several times each day. Taking iron with a citrus juice can help your body take it in. Antacids may make it harder for your body to take in iron. Iron supplements may cause nausea and cause stools to become dark greenish or black in color. They may also cause constipation.
Prevention of anemia
Good pre-pregnancy nutrition not only helps prevent anemia, but also helps build other nutritional stores in the mother's body. Eating a healthy and balanced diet before and during pregnancy helps keep up your levels of iron and other important nutrients needed for your health and that of your growing baby.
Good food sources of iron include the following:
Meats. Beef, pork, lamb, liver, and other organ meats.
Poultry. Chicken, duck, turkey, liver (especially dark meat).
Fish. Shellfish, including (fully-cooked) clams, mussels, and oysters are good. So are sardines and anchovies. The FDA recommends that pregnant women eat 8 to 12 ounces per week of fish that are lower in mercury. These include salmon, shrimp, pollock, cod, tilapia, and catfish. Don't eat the following fish because they are highest in mercury: tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel. Limit white (albacore) tuna to only 6 ounces per week.
Leafy greens of the cabbage family. These include broccoli, kale, turnip greens, and collards.
Legumes. Lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans.
Yeast-leavened whole-wheat bread and rolls
Iron-enriched white bread, pasta, rice, and cereals
Vitamin supplements containing at least 400 micrograms of folic acid are recommended for all women of childbearing age and during pregnancy. Food sources of folate include the following:
Leafy, dark green vegetables
Dried beans and peas
Citrus fruits and juices and most berries
Fortified breakfast cereals
Enriched grain products