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Anaemia In Pregnancy


Anaemia is a condition whereby the level of red blood cells and haemoglobin in the blood is abnormally low. How would developing anaemia during pregnancy affect your own baby's health? During pregnancy, the amount of blood in your body has to increase significantly, as it not only has to meet your body's demands, it has to deliver adequate oxygen and nutrients to the growing foetus as well.

As a result, the mother's body has to start making blood at a much faster pace. Sometimes the body is unable to keep up with the production and ends up with a shortage of haemoglobin and red blood cells; this results in anaemia.

What Causes Anaemia?

Consultant obstetrician and gynaecologist, Dr Annie says that the majority of the anaemic cases stem from nutritional deficiencies. "Iron deficiency accounts for 90 percent of all anaemic cases in pregnancy. Folic acid deficiency accounts for 5 percent of the anaemic cases, whereas genetic disorders such as Thalassaemia accounts for less than 5 percent," she elaborates.

Treatment for anaemia is depend ent on the cause. Iron is essential for making haemoglobin. If you do not have prior medical history of iron deficiency, and find yourself developing the condition only during pregnancy, it is be cause your body's iron requirements go up significantly when you're pregnant. During pregnancy, the amount of blood in your body expands until you have almost 50 percent more than usual. And you need more iron to make more haemoglobin for all that additional blood.

You also need extra iron for your growing baby and placenta. Unfortunately, most women start pregnancy without sufficient stores of iron to meet their body's increased demands, particularly in the second and third trimesters. If you get to the point that you do not have enough iron to make the haemoglobin you need, you become anaemic. Anaemia stemming from folic acid deficiency is caused in a similar manner. Folic acid is a B vitamin that is used by our bodies to generate new cells. Adequate folic acid is needed to help prevent major birth defects in the baby's brain and spine.

Other Possible Causes Of Anaemia During Pregnancy Include

  • Loss of blood from bleeding haemorrhoids or gastrointestinal bleeding.
  • Sickle-Cell Anaemia - a condition where your body produces red blood cells which are abnormally shaped. This causes the red blood cells to be blocked in the blood vessel. This condition could in turn be passed on to your baby. Sickle-cell anaemia is easily picked up by means of a blood test.
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Women who are already anaemic before pregnancy may experience a worsening of the condition during their pregnancy. Women are prone to developing anaemia because as Dr Annie puts it, "they have regular blood loss through their menses on a monthly basis, and this is made worse if their nutrition is inadequate:"
  • Women who are expecting multiples may be at a higher risk of developing anaemia, as two babies would deplete iron stores twice as much. Women who have two or more pregnancies relatively close together may be at risk for similar reasons.
  • Medical history of any disorder that reduces absorption of nutrients by the body.

Possible Risks

If you remain anaemic during the first two trimesters, you're at a higher risk of experiencing pre-term delivery, and your baby may end up with low-birth weight. Anaemia can also sap your energy and make it harder for your body to fight infection. And if you're severely deficient, it could retard the foetus' growth and mental development, and affect your baby's iron stores at birth, thus increasing his risk for anaemia later in infancy.

If you're anaemic later in pregnancy, you're more likely to have problems if you lose a lot of blood when you give birth. You may feel dizzy, experience heart palpitations, or have other symptoms that require you to stay in the hospital an extra day or two. You're also more likely to need a blood transfusion, and there is an increased susceptibility of maternal infection after childbirth In general, those with anaemia tend to tire easily, therefore, it is essential for pregnant mothers with anaemia to get adequate rest until their condition improves.

"If the cause of the anaemia is a dietary deficiency, then the condition can be easily reversed with adjustments to the diet and suitable supplements prescribed," Dr Annie explains. Foods rich in iron include red meat, whole grain breads and cereals, eggs, dried beans and fruits, and leafy green vegetables. Women with folic acid deficiency should eat more wheat germ, beans, peanut butter, oatmeal, mushrooms, collards, broccoli, beef liver and asparagus in their diet.

In addition, it would be beneficial to eat foods high in vitamin C, such as citrus fruits and fresh, raw vegetables, as Vitamin C aids iron absorption by the body. Iron, folic acid and/or other supplements may also be prescribed by your doctor to counter the nutritional deficiency. Try to have your iron supplements an hour before eating, or between meals for better absorption.

Keep in mind that your choice of beverages and other foods will affect your rate of iron absorption as well. Calcium interferes with your body's ability to absorb iron. So if you're taking calcium supplements, or an antacid that contains calcium, don't take either one while you're eating iron-rich foods or at the same time as your iron supplement. For the same reason, don't take your supplement with milk, which is rich in calcium.

Drink milk between meals instead. The same goes for tea and coffee, which contain polyphenols that interfere with the absorption of iron. On the other hand, taking your iron pill with orange juice (or vitamin C rich foods) will help it be absorbed more easily. "Conversely, if the cause of anaemia is due to a genetic defect, pre-pregnancy investigations and counselling are necessary," Dr Annie advises.

Screening for genetic defects such as G6PD deficiency, Thalassemia and sickle cell disease should be considered essential for women prior to any attempt to become pregnant. This is because genetic defects are hereditary; there is a high risk that the mother will pass on the responsible genetic defect to her child. This is even more so when both parents carry the similar defect and if they do, there is a 25 percent chance of a major defect which is either lethal or carries high morbidity.

Women Who Have Anemia May Experience The Following Signs And Symptoms

  • Breathlessness
  • Easily tired/bouts of extreme fatigue
  • Feeling of weakness
  • Fainting spells/dizziness
  • Looking pale
  • Heart palpitations
  • Nausea
  • Frequent headaches
  • Trouble concentrating
 

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