Anemia in Pregnancy - Causes, Symptoms, and Prevention

Introduction:

Anemia is a condition characterized by a deficiency of red blood cells required to carry adequate oxygen to the body's tissues. There is an increased risk of anemia during pregnancy because the body needs more blood to support the baby's growth. If the mother is not well nourished, there will be decreased production of red blood cells, leading to anemia. There are usually four types of anemia that develop during pregnancy. A mild form of anemia is normal, but severe anemia poses a serious risk to a baby's health later in life.

Who May Get Anemia During Pregnancy?

• People who follow a vegetarian diet and vegans.

• Individuals on a poor diet.

• History of anemia before pregnancy.

• History of heavy periods before pregnancy.

• Pregnant with two or more babies.

• Pregnant teenagers.

• Two pregnancies are close together.

• Increased vomiting due to morning sickness.

Is Anemia During Pregnancy Preventable?

Pre-pregnancy counseling helps to overcome problems related to pregnancy. A good and nutritious diet, including vitamins, minerals, and calcium, is essential for a baby's growth and the mother's health. It is advisable to take iron and folic acid supplements as the doctor prescribes. Mothers with high-risk or multiple pregnancies should take frequent blood tests. Pregnant women should take a complete blood count during the first prenatal visit.

What Are the Tests Available to Check Anemia?

A few blood tests are carried out in the first prenatal visit to evaluate anemia and its type, which are:

• Hemoglobin Test - To check the amount of hemoglobin in the blood.

• Hematocrit Test - To measure the proportion of red blood cells (RBC) in the blood.

• Serum Folate - To evaluate the folate (an essential B vitamin in red and white blood cell production) level.

• Vitamin B12 - To assess vitamin B12 levels.

What Are the Causes of Anemia?

There are different kinds of anemia, and the causes vary according to their type.

• Physiological Anemia or Dilutional Anemia - This is a normal condition during pregnancy. In delusional anemia, an overall increase in blood volume during pregnancy can be seen, which requires increased iron and vitamins to produce red blood cells. If iron production is deficient, there are chances of anemia.

• Deficiency in Iron Stores Before Pregnancy - Iron deficiency anemia may be due to a deficiency in iron stores before pregnancy. Iron is an essential component in the production of red blood cells. The fetus uses these red blood cells to grow and develop during pregnancy, mainly in the last three months. Therefore, there should be additional iron stores to compensate for the loss. A good diet and pre-pregnancy counseling are essential to avoid this condition.

• Folate Deficiency Anemia - Folate is a water-soluble vitamin that, together with iron, helps in cell growth. The deficiency in folate leads to brain and spinal cord disorders in babies. Therefore, doctors recommend folic acid even before getting pregnant to avoid any anomalies.

• Vitamin B12 Deficiency (Pernicious Anemia) - Vitamin B12 helps produce red blood cells and proteins. Vitamin B12 supplements are advised for vegetarians. Dairy products, eggs, meat, and poultry are rich in vitamin B12. People who do not include these foods in their diet are at high risk of developing anemia. Pernicious anemia also causes an anemic tongue, a condition in which the tongue surface appears red instead of pinkish (the normal color of the tongue), appears beefy or thick, and is swollen or cracked in texture.

What Are the Symptoms of Anemia During Pregnancy?

Symptoms of anemia occur when the red blood cell count falls very low.

The following are a few common symptoms of anemia during pregnancy:

• Feeling tired often.

• Weakness.

• Feeling giddy.

• Paleness of the skin, conjunctiva of the eyes, nails, lips, and palms.

• Hair loss.

• Dry skin.

• Problem with breathing.

• Increased heartbeat.

• Sore tongue.

• Trouble concentrating.

• Craving for non-food items like clay, paper, and cornstarch.

Symptoms of anemia one must worry about during pregnancy:

• Fast heartbeat.

• Dizziness.

• Sore throat.

• Headaches.

• Pale skin.

• Unintended movement in lower legs.

Does Anemia During Pregnancy Affect the Fetus?

When the iron supply does not meet the demand, it may affect the unborn child.

The effects include:

• Premature birth (birth that takes place earlier than the estimated date).

• The cognitive performance, behavior, and growth of infants are affected.

• The immune system is depressed, leading to morbidity from infections of all ages.

• Intrauterine death (death of the baby in the uterus).

• Increased neonatal death (when a baby dies within a month of birth).

• Stillbirth (loss of a baby during delivery),

• Increased chance of iron deficiency in early infancy.

• It adversely affects the muscle's energy source, which affects infants' physical capacity and work performance.

How Can Anemia During Pregnancy Be Treated?

Anemia treatment depends on the patient's age, symptoms, and general health. The severity of the condition is also assessed before treatment.

• Intake of Iron Supplements - These may be advised several times a day. The conception of iron with citrus items like lemon, orange, and kiwi helps better absorb iron. On the other side, antacids make iron absorption difficult; therefore, it is advised to avoid taking these together. Iron supplementation can also cause constipation, nausea, and dark greenish or black discoloration of stools.

• Folic Acid and Vitamin B12 Supplements - If folic acid or vitamin B12 deficiency causes anemia.

• Transfusion - If a patient has severe anemia or fatal indications.

• Dietary Changes - Intake of foods rich in iron is advised.

What Are the Foods to Be Taken to Prevent Anemia?

Eating a healthy and balanced diet prevents anemia during pregnancy, builds iron stores, and improves the overall growth and development of the baby.

Increased iron content is available in the following food.

• Leafy, dark green vegetables like spinach, broccoli, turnip, and kale.

• Legumes like beans, green peas, and black-eyed peas.

• Citrus fruits and berries such as oranges, lemons, and blueberries.

• Dry fruits and nuts like dates, almonds, and flaxseeds.

• Whole wheat bread and rolls are enriched with iron.

• Lamb, liver, pork, beef, and other meat products.

• Poultry products like chicken, duck, and turkey.

• Seafood - Shellfish like clams, muscle, and oysters are good sources of iron. Salmon, shrimp, catfish, and tuna, which have less mercury content, are recommended, whereas fish like sharks, swordfish, and the Gulf of Mexico have high mercury content, thus, they are not recommended for conception.

Conclusion:

Anemia during pregnancy is becoming more common in developing countries. Steps should be taken to rule out the onset of anemia in early pregnancy through pre-pregnancy counseling and a proper, healthy, and nutritious diet regime. Early diagnosis and appropriate treatment planning will reduce the severity of anemia during pregnancy. Therefore, one must consult the doctor immediately if they experience such symptoms during pregnancy.