Anaemia During Pregnancy: Types, Causes, and Treatments

Pregnancy is a time of rapid changes in a woman’s body. One of these changes is an increased need for certain nutrients, including iron, folate, and vitamin B12. Anemia is a common issue that can occur during pregnancy, and it is crucial to address it to ensure the health of both the mother and the baby. This article discusses different types of anemia, why pregnant women are susceptible to it, and how it can be treated and prevented.

Types of Anemia During Pregnancy

There are several types of anemia that can affect pregnant women, including:

• Folate-deficiency anemia
• Vitamin B12 deficiency anemia
• Iron-deficiency anemia

What are red blood cells?

Red blood cells are essential for carrying oxygen from the lungs to the rest of the body. They contain a protein called hemoglobin, which binds to oxygen and transports it to the tissues. Anemia occurs when there are not enough red blood cells or when the hemoglobin level is lower than normal.

Why do pregnant women become anemic?

Pregnant women are at higher risk for anemia due to the increased demand for nutrients that support the growth of the baby and the expansion of the mother’s blood volume. As the blood volume expands, the concentration of red blood cells may decrease, leading to anemia.

Folate-deficiency anaemia

Folate, also known as folic acid or vitamin B9, is crucial for the formation of red blood cells and the development of the baby’s neural tube. A deficiency in folate can lead to anemia and increase the risk of neural tube defects in the baby. Pregnant women should consume at least 600 mcg of folate daily through prenatal vitamins and a balanced diet.

Vitamin B12 deficiency anaemia

Vitamin B12 is essential for the formation of red blood cells and the proper functioning of the nervous system. A deficiency in vitamin B12 can lead to anemia and may also cause irreversible damage to the baby’s nervous system. Pregnant women should consume 2.6 mcg of vitamin B12 daily through animal-based foods or supplements.

Iron-deficiency anaemia

Iron-deficiency anaemia is the most common type of anaemia during pregnancy. Iron is essential for the production of hemoglobin, and a deficiency can lead to a reduced number of red blood cells and a decreased ability to transport oxygen throughout the body.

What causes iron deficiency anaemia during pregnancy?

Several factors can contribute to iron deficiency anaemia during pregnancy, including:

• Increased iron requirements: Pregnant women need more iron to support the growth of the baby and the expansion of their blood volume.
• Inadequate iron intake: A diet low in iron-rich foods can lead to iron deficiency.
• Blood loss: Heavy menstrual bleeding or blood loss during childbirth can deplete iron stores.

How does iron deficiency anaemia during pregnancy affect the baby?

Iron deficiency anaemia during pregnancy can have serious consequences for both the mother and the baby. For the mother, it can lead to fatigue, shortness of breath, and an increased risk of infection. For the baby, it can cause low birth weight, premature birth, and developmental delays.

What are the risk factors for iron deficiency anemia during pregnancy?

Some factors that may increase the risk of developing iron deficiency anemia during pregnancy include:

• Having two or more pregnancies close together
• A history of heavy menstrual bleeding
• A vegetarian or vegan diet
• A history of gastrointestinal disorders that affect iron absorption

What are the symptoms of iron deficiency anaemia during pregnancy?

Symptoms of iron deficiency anaemia during pregnancy may include:

Fatigue and Weakness

Iron deficiency anemia causes fatigue because it impairs the body’s ability to transport oxygen to tissues and organs. This impairment is a result of low levels of iron in the body, leading to a decrease in the production of hemoglobin, the protein found in red blood cells responsible for carrying oxygen.

Hemoglobin binds to oxygen in the lungs and transports it to tissues and organs throughout the body. When there is not enough iron to produce adequate amounts of hemoglobin, the number of oxygen-carrying red blood cells decreases, and the body’s oxygen-carrying capacity is reduced. This diminished oxygen supply to tissues and organs, including muscles and the brain, causes the body to work harder to meet its oxygen needs, resulting in fatigue and weakness.

Pale skin

Iron deficiency anaemia causes pale skin due to the reduced amount of haemoglobin in red blood cells. Haemoglobin, an iron-containing protein, is responsible for giving red blood cells their characteristic red colour. When there is a lack of iron in the body, haemoglobin production decreases, leading to a reduction in the number and size of red blood cells. Consequently, this causes a decreased concentration of haemoglobin in the bloodstream.

Haemoglobin in red blood cells imparts a reddish hue to the blood, which in turn gives the skin a healthy, rosy appearance. When the hemoglobin concentration is reduced due to iron deficiency anemia, less oxygen-carrying red blood cells circulate through the small blood vessels, or capillaries, in the skin. This causes the skin to appear paler than usual.

Shortness of breath and dizziness

Iron deficiency anemia causes shortness of breath and dizziness because it reduces the body’s ability to transport oxygen efficiently. This is due to the low levels of iron in the body, which leads to decreased production of haemoglobin, the protein found in red blood cells responsible for carrying oxygen.

Haemoglobin binds to oxygen in the lungs and transports it to tissues and organs throughout the body. When there is not enough iron to produce adequate amounts of haemoglobin, the number of oxygen-carrying red blood cells decreases, and the body’s oxygen-carrying capacity is reduced. As a result, the body’s tissues and organs receive less oxygen than they require for normal functioning.

Headaches

The brain is highly sensitive to changes in oxygen levels, and when the oxygen supply is insufficient, it can cause various symptoms, including headaches. The exact mechanism by which low oxygen levels lead to headaches is not entirely understood, but it may involve the dilation of blood vessels in the brain, changes in blood flow, or the triggering of pain-sensitive nerve fibers.

Headaches caused by iron deficiency anaemia can range from mild to severe and may be accompanied by other symptoms, such as fatigue, weakness, pale skin, dizziness, shortness of breath, and rapid heartbeat. Addressing iron deficiency anaemia through proper nutrition, supplementation, and medical care is crucial for managing these symptoms and maintaining overall health.

Cold hands and feet

Iron deficiency anemia can cause cold hands and feet due to its impact on blood circulation and oxygen delivery to the extremities. The reduced production of haemoglobin, caused by low iron levels, results in a decrease in the number of oxygen-carrying red blood cells.

When the body’s oxygen-carrying capacity is reduced, the amount of oxygen reaching various tissues, including those in the extremities like hands and feet, is also diminished. In response to this reduced oxygen supply, the body may prioritise the delivery of blood and oxygen to vital organs, such as the heart and brain, by constricting the blood vessels in the extremities. This constriction of blood vessels reduces blood flow to the hands and feet, making them feel cold.

Additionally, poor circulation can cause the extremities to be more sensitive to changes in temperature, further exacerbating the sensation of cold hands and feet. This symptom may be more pronounced in colder environments or during periods of inactivity.

Difficulty concentrating

Iron deficiency anaemia can cause difficulty in concentrating due to its impact on the brain’s oxygen supply and overall cognitive function. The reduced production of haemoglobin, caused by low iron levels, leads to a decrease in the number of oxygen-carrying red blood cells. When the oxygen supply is insufficient, it can affect various cognitive functions, including attention, concentration, and memory.

There is also evidence suggesting that iron plays a direct role in various neurological processes, such as neurotransmitter synthesis and myelin production, which are crucial for cognitive function. In cases of iron deficiency anemia, the lack of iron may negatively affect these processes, further contributing to difficulties in concentrating and other cognitive impairments.

Cravings for non-food items (pica)

Iron deficiency anaemia can cause cravings for non-food items, a condition known as pica, due to the body’s attempt to compensate for the lack of essential nutrients. Although the exact mechanism behind this phenomenon is not fully understood, it is believed to be related to the body’s response to the deficiency.

Pica is characterised by persistent cravings and consumption of non-food substances such as ice, clay, dirt, paper, chalk, or laundry starch. These cravings are thought to be the body’s attempt to obtain missing nutrients, such as iron, from non-food sources. However, consuming these non-nutritive substances does not provide the body with the required nutrients, and in some cases, it can lead to further health complications or even be toxic.

It is important to note that pica is not exclusive to iron deficiency anaemia and can also be associated with other nutritional deficiencies, such as zinc or calcium deficiencies, as well as psychological factors.

If someone with iron deficiency anemia experiences cravings for non-food items, it is crucial to consult a healthcare provider for proper diagnosis and treatment. Addressing the underlying cause of the deficiency through proper nutrition, supplementation, and medical care is essential for managing these cravings and maintaining overall health.

How can iron deficiency anaemia during pregnancy be prevented and treated?

Prevention and treatment of iron deficiency anaemia during pregnancy are crucial for ensuring the health of both the mother and the baby. Various strategies can be employed to prevent and manage this condition:

• Prenatal vitamins: Pregnant women should take prenatal vitamins that contain iron, folic acid, and vitamin B12. These vitamins help meet the increased nutritional demands of pregnancy and support the production of red blood cells and hemoglobin. Prenatal vitamins are typically prescribed by healthcare providers, and it is essential to follow their recommendations regarding the appropriate dosage and frequency.
• Iron-rich diet: Consuming a diet rich in iron-containing foods can help maintain adequate iron levels during pregnancy. Iron-rich foods include lean meats, poultry, fish, beans, lentils, tofu, fortified cereals, and leafy green vegetables such as spinach and kale. Consuming a variety of these foods can help ensure an adequate intake of iron.
• Iron supplements:If a pregnant woman is diagnosed with iron deficiency anemia, her healthcare provider may recommend additional iron supplements in addition to prenatal vitamins. These supplements are available in various forms, such as tablets, capsules, or liquid, and the healthcare provider will advise on the appropriate dosage and duration of treatment.
• Vitamin C: Certain dietary factors can enhance iron absorption from plant-based sources. Including vitamin C-rich foods or supplements in the diet can improve the absorption of non-heme iron, which is found in plant-based foods. Consuming foods rich in vitamin C, such as citrus fruits, berries, tomatoes, and peppers, alongside iron-rich foods can help maximise iron absorption.
• Avoiding iron inhibitors: Some substances can inhibit iron absorption, such as calcium, polyphenols (found in tea and coffee), and phytates (found in some grains and legumes). Pregnant women should be mindful of their consumption of these substances and consider consuming them separately from iron-rich meals.
• Monitoring: Attending regular prenatal checkups allows healthcare providers to monitor the mother’s iron levels and overall health throughout pregnancy. If iron deficiency anemia is detected early, it can be treated more effectively, reducing the risk of complications for both the mother and the baby.

It is essential to work closely with a healthcare provider to manage iron-deficiency anemia during pregnancy. They can recommend appropriate supplements, dietary changes, and monitoring strategies to ensure the health of both the mother and the baby. Through early detection and intervention, the risks and complications associated with iron-deficiency anaemia during pregnancy can be significantly reduced.

Treatment for Other types of Anaemia

Folate-deficiency anaemia and vitamin B12 deficiency anaemia can be treated with the appropriate supplements as recommended by a healthcare provider. In some cases, injections or high-dose oral supplements may be necessary. It is essential to work closely with a healthcare professional to determine the best course of action for treating these types of anaemia during pregnancy.

Starting pregnancy in good health

To reduce the risk of anaemia and other complications during pregnancy, it is essential to start pregnancy in good health. This includes:

• Eating a balanced diet rich in essential nutrients, such as iron, folate, and vitamin B12
• Maintaining a healthy weight
• Taking prenatal vitamins, as recommended by a healthcare provider
• Seeking early and regular prenatal care
• Avoiding alcohol, tobacco, and other harmful substances

Anaemia during pregnancy, particularly iron deficiency anaemia, is a common yet preventable and treatable condition that can have significant consequences for both the mother and the baby if left unaddressed. It is crucial for pregnant women to be aware of the risk factors, symptoms, and potential complications of anemia in order to take appropriate preventative measures and seek prompt medical care if needed.

Prevention and treatment of anemia during pregnancy involve a combination of strategies. Starting pregnancy in good health and maintaining a balanced diet with adequate nutrients, such as iron, folic acid, and vitamin B12, can significantly reduce the risk of developing anemia during pregnancy. By being proactive and attentive to their health, pregnant women can minimise potential complications associated with anemia and contribute to a healthier pregnancy outcome for both themselves and their babies.