Anemia in pregnancy
Anemia in pregnancy is common and treatable. The most common symptoms are fatigue and weakness. Your doctor will check your blood work for anemia at your first prenatal visit and advise you about taking iron supplements. (You may need more iron than your prenatal vitamin provides) You can help prevent anemia in pregnancy by getting at least 27 mg of iron daily through your diet and supplements.
What causes anemia in pregnancy?
Blood Dilution happens in pregnancy. Besides the increased risk from pregnancy itself, you're also at higher risk of anemia while pregnant if you:
Had heavy menstrual periods before becoming pregnant
Have a diet low in iron-rich foods
Have a diet low in vitamin-C-rich foods (which help with iron absorption)
Eat too many foods or drinks that reduce iron absorption (like dairy products, foods containing soy, coffee, and tea)
Had a short gap between pregnancies
Were you younger than 20 when you become pregnant
Have a stomach or intestinal disease that affects how your body absorbs nutrients
Have a disease that increases anemia risk, such as hypothyroidism, chronic kidney disease, or inherited blood disorders such as sickle cell disease or thalassemia
Had certain types of gastric bypass surgery, which alters the gut and absorption of nutrients
Take medication that affects the way your body absorbs iron from food
Lost more blood than normal when giving birth previously, or lost a lot of blood for any other reason
Aren't getting enough folic acid
Aren't getting enough vitamin B12
Are pregnant with multiples
Had a history of anemia before your pregnancy
Have or had morning sickness (You may not have been able to keep your prenatal vitamins and/or iron supplements down, and/or you may not have gotten enough iron-rich foods.)
Symptoms of anemia in pregnancy
Fatigue and weakness are the most common
Headache
Dizziness, feeling lightheaded when you stand up
Hair loss
Craving nonfood items (pica) or ice to suck or chew on
Leg cramps, and/or an unpleasant urge to move your legs during periods of inactivity (restless legs syndrome)
Palpitations, rapid heartbeat
Chest pain
Irritability or poor concentration
Spoon-shaped nails
Glossy tongue
Cracks in the corners of your mouth
Brittle nails
Blue color in the whites of the eye
Pale complexion. Pale lips, inner eyelids, and inside your mouth
Shortness of breath
Sore or inflamed tongue
Mouth ulcers
How is anemia in pregnancy diagnosed?
One of the blood tests you'll have is a complete blood count (CBC). Among other things, the CBC measures the amount of hemoglobin (Hgb or Hb) in those red blood cells
First trimester: Hemoglobin (Hgb) level of less than 11 grams /dl
Second trimester: Hgb <10.5 g/dL
Third trimester: Hgb <10.5 to 11 g/dL
Postpartum: Hemoglobin 10g/dL
Will anemia affect my pregnancy or my baby?
Severe anemia in pregnancy (especially in the first two trimesters) can increase the risk of:
Preterm birth
Low birth weight
Small for gestational age baby
Postpartum depression
Complications from blood loss during labour and delivery (You're not more likely to lose blood, but you may be more likely to need a transfusion or feel weak.)
Stillbirth and newborn death
Treatment for anemia in pregnancy
Iron deficiency anemia in pregnancy is usually easy to treat with iron supplements. (If you're anemic, it will be difficult to get enough iron from your diet alone.)
Tips for taking your iron supplement
Iron is best absorbed on an empty stomach, but many women can't easily tolerate iron supplements. (They can cause nausea, cramping, and diarrhea in some women.) So you may want to take yours with a small snack.
Take your iron supplements with a source of vitamin C, because vitamin C helps iron absorption. Orange juice is a good source, but it gives many pregnant women heartburn. Some iron supplements – usually prescription varieties or liquid varieties – contain this extra vitamin C already. If yours doesn't, you can take a little vitamin C supplement at the same time.
Avoid dairy products, spinach, caffeine, soy products, and whole grain bread and cereals for one hour before and two hours after you take your iron supplements. These foods can all decrease iron absorption.
Don't take antacids or calcium supplements at the same time as your iron supplements. Take them an hour or two apart.
If your supplements make you nauseated, try taking them right before bed. Nausea hopefully won't bother you while you're asleep.
If you're having trouble keeping your iron supplements down, you might try taking smaller amounts throughout the day. Or talk with your doctor about trying another form of iron. There are gummy and liquid formulas in addition to countless standard pill options. Prescription iron supplements are sometimes easier to tolerate but can be expensive. If you're unable to take oral iron supplements, iron infusions are available.
To prevent constipation (a common side effect of iron supplements), drink plenty of water, exercise regularly, and consider adding resins or grape juice to your diet. Stool softeners such as docusate sodium are safe and commonly taken during pregnancy for constipation. Ask your provider for a recommendation.
If you're taking liquid iron supplements, mix the liquid with water or juice and drink it with a straw to prevent staining your teeth.
Store iron tablets in a cool, dry place (or they may crumble). Be sure to keep the out of the reach of children.
There are things you can do to reduce your risk of developing anemia in pregnancy.
Include good sources of iron in your diet.
Lean red meats, iron-fortified cereals, eggs, peanuts, and beans are some good iron sources. Include foods that enhance iron absorption, too, such as orange juice, strawberries, broccoli, grapefruit, and peppers. Take supplements.
Take a prenatal vitamin before and during pregnancy and for as long as you're breastfeeding.
