Anaemia, during pregnancy, is a common condition characterised by a decrease in red blood cells (RBCs) or the amount of hemoglobin in the blood, leading to reduced oxygen flow to the body's organs and tissues. When pregnant, a woman's body requires more iron and vitamins to support her health and the development of her baby. Failure to meet these increased demands can result in anaemia, making it a significant health concern during pregnancy.
Iron deficiency is the most prevalent cause of anaemia in pregnancy. Iron is vital for making hemoglobin , the protein in RBCs that carries oxygen to various parts of the body. During pregnancy, the need for iron nearly doubles as the maternal blood volume increases to support the growing fetus, often leading to a shortfall if not compensated with adequate dietary intake.
Folate, or vitamin B9, is essential for the production and maintenance of new cells, including RBCs. A deficiency in folate during pregnancy can lead to megaloblastic anaemia, where RBCs are larger than normal but fewer in number, impairing their oxygen-carrying capacity. Pregnant women are at an increased risk because folate is crucial for fetal development, particularly the neural tube.
Vitamin B12 deficiency can also result in anaemia during pregnancy. This vitamin is necessary for RBC formation and neurological function. A lack of B12 can cause megaloblastic anaemia, similar to folate deficiency, affecting the mother's and baby's health. Dietary sources of B12 include meat, eggs and dairy products, putting those with dietary restrictions at higher risk.
Anaemia is typically diagnosed through a complete blood count (CBC) test, which measures the levels of various components in the blood, including hemoglobin and hematocrit. A hemoglobin level of less than 11 grams per decilitre in the first and third trimesters and less than 10.5 grams per decilitre in the second trimester is generally considered indicative of anaemia in pregnancy.
Pregnant women should undergo routine blood tests to check for anaemia during their first prenatal visit and again in their second trimester. However, more frequent testing may be necessary for those with ongoing symptoms of anaemia or those at higher risk due to diet, previous anaemia or chronic conditions. At the booking visit, in selected patients, specific tests are run to rule out hemoglobinopathies like Thalassemia or Sickle Cell Disease.
The cornerstone of managing mild to moderate anaemia in pregnancy involves dietary modifications to increase the intake of iron, vitamin B12 and folate. Foods rich in iron include lean meats, beans, lentils and fortified cereals, while folate can be found in leafy green vegetables, nuts and citrus fruits. Vitamin B12 is primarily found in animal products like meat and dairy. In addition to dietary changes, iron and folate supplements are commonly prescribed to pregnant women to meet their increased needs.
For more severe cases of anaemia, oral iron supplements may not be sufficient, and intravenous iron therapy or even blood transfusions may be necessary. Intravenous /Parenteral iron therapy is more suitable for women who are unable to tolerate oral iron or, have malabsorption issues, or have moderate anaemia close to delivery. These treatments are typically administered under the guidance of a healthcare provider to ensure the safety of both the mother and the baby.
Addressing nutritional deficiencies before becoming pregnant can significantly reduce the risk of developing anaemia. Women of childbearing age should consider taking multivitamin supplements containing iron and folate, especially if their diet lacks these nutrients.
Regular prenatal visits that include blood tests can help identify anaemia early in pregnancy, allowing for timely intervention. These screenings are crucial for monitoring the health of the mother and the developing fetus and for making any necessary adjustments to dietary or supplement intake.
