Pregnancy

Iron deficiency / Anaemia in pregnancy

Discovering that you are pregnant is a rollercoaster of excitement, and worry. All of a sudden your mind races through the last few weeks – I had a glass of wine, will that damage the baby? What you put into your body suddenly has greater significance – and for good reason.

Whilst you cut out the potentially harmful things from your diet, you mustn’t forget to add in the things you need more of. You can’t quite start eating for two, but you will need to increase your intake of certain nutrients, like iron, to keep you and your baby healthy.

You can also download the “Iron deficiency / Anaemia in pregnancy” article as a PDF.

Why do I need more iron now?

Iron is needed for your body to work properly every day. Now it is important, not just for you, but also for a healthy pregnancy and developing baby.1

To support the growth of a baby your body goes through lots of changes. Alongside the nausea and stretch marks you may also start to get that pregnancy glow and wonderfully thick hair – all side effects of the amazing changes going on inside.

Iron is not only important for the changes going on in your body, but also for the growth of your baby. In the last trimester your baby stores 80% of the iron it needs to continue to grow for the first 6 months of its life.2

How will I know if I’m low in iron?

If your iron levels get particularly low, you can develop iron deficiency anaemia. This is when you don’t have enough iron for your body to make enough fully working red blood cells to carry the normal amounts of oxygen around your body. Having iron deficiency anaemia can affect your pregnancy and the growth of your baby,3 and you will likely be checked for anaemia as part of your normal pregnancy screening tests.

Signs that you may have low iron levels and/or iron deficiency anaemia, include feeling listless or washed out, looking pale or feeling breathless. Cravings are often joked about during pregnancy – dashing out for ice-cream in the middle of the night or a never ending desire for pickled onions. But having iron deficiency anaemia can also cause you to crave strange things, including ice, or even dirt. If you feel your cravings are becoming unusual, or you think you have any of the other signs of iron deficiency such as faintness or feeling fatigued4, you should talk to your doctor who will be able to find out the most likely cause of your symptoms.

I may be low in iron, what can I do?

Although your doctor or midwife will check for signs of iron deficiency anaemia you may only have low iron levels, without developing anaemia yet. This can still have an impact on your pregnancy,5 so it is important that you know the signs of iron deficiency and how to increase the amount of iron you are getting from your diet.

If you are worried that you may have iron deficiency, don’t be afraid to schedule an extra visit to see your doctor. They will be able to check your iron levels and give you advice.

Remember that the amount of iron you need changes with each trimester so make sure your physician keeps an eye on it throughout your pregnancy.

Delivery and early days

Once the initial excitement of becoming pregnant has passed, and as the bump grows, your mind turns to the delivery. And, no matter how smooth, there is no avoiding the fact that some blood loss will be involved during your baby’s birth. Although serious blood loss is rare (5-6% of women)6 and is treated in hospital, being anaemic after birth is common.7

Being anaemic during the early days at home with your baby can increase your chance of suffering from postnatal depression,8 whilst having iron deficiency anaemia can reduce the quality of your breastmilk9 and impact upon your ability to care for your baby.6

The difference between fatigue and everyday tiredness

You may think that fatigue is just part of what comes with being pregnant and having a baby, and it is true that you will feel extremely tired at times. But fatigue is different. It is a feeling of both physical and mental exhaustion10 day after day and is associated with iron deficiency and iron deficiency anaemia.4

References

  1. Milman N. Prepartum anaemia: prevention and treatment. Ann Hematol. 2008;87(12):949-59. doi:10.1007/s00277-008-0518-4.
  2. Baker RD, Greer FR. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-50. doi:10.1542/peds.2010-2576.
  3. Milman N. Prepartum anaemia: prevention and treatment. Ann Hematol. 2008;87(12):949-59. doi:10.1007/s00277-008-0518-4.
  4. Wood MM, Elwood PC. Symptoms of iron deficiency anaemia: A community survey. Br J Prev Soc Med. 1966;20:117-121.
  5. World Health Organization. Iron deficiency anaemia. Assessment, prevention and control: A guide for programme managers.; 2001:1-114.
  6. Milman N. Postpartum anemia I: definition, prevalence, causes, and consequences. Ann Hematol. 2011;90(11):1247-53. doi:10.1007/s00277-011-1279-z.
  7. Breymann C, Gliga F, Bejenariu C, Strizhova N. Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. Int J Gynaecol Obstet. 2008;101(1):67-73. doi:10.1016/j.ijgo.2007.10.009.
  8. Corwin EJ, Murray-kolb LE, Beard JL. Low Hemoglobin Level Is a Risk Factor for Postpartum Depression. J Nutr. 2003;133(August):4139-4142.
  9. França EL, Silva VA, Volpato RMJ, Silva PA, Brune MFSS, Honorio-França AC. Maternal anemia induces changes in immunological and nutritional components of breast milk. J Matern Fetal Neonatal Med. 2013;26(12):1223-7. doi:10.3109/14767058.2013.776529.
  10. Dittner AJ, Wessely SC, Brown RG. The assessment of fatigue: a practical guide for clinicians and researchers. J Psychosom Res. 2004;56(2):157-70. Available at: http://www.ncbi.nlm.nih.gov/pubmed/15016573. Accessed September 21, 2013.