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Iron Deficiency in Pregnancy

Iron Deficiency in Pregnancy
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According to the Australian journal of general practice Anaemia in pregnancy is a significant global health problem, with 38% of women worldwide affected, predominantly because of an iron deficiency.

What is Iron Deficiency?

Iron deficiency is a progressive process, in which iron stores fall, from being replete to deplete and finally absent, consequently resulting in iron deficiency anaemia. In pregnancy, iron deficiency is usually due to an imbalance of demand and supply, which worsens as pregnancy advances. Iron utilisation is increased during pregnancy, as iron is required for foetal growth and development.

What is Haemoglobin?

Haemoglobin is a protein found in red blood cells. It picks up oxygen from the lungs and carries it around the body. A key ingredient used to make haemoglobin is iron. If there isn’t enough iron stored in the body, then the amount of haemoglobin drops. When haemoglobin reaches a low level, less oxygen can be carried in the blood. Iron sufficiency is essential for oxygen delivery to the maternal-placental-foetal unit to support the increased oxygen consumption demand of pregnancy.

The importance of Iron in Pregnancy:

During pregnancy, your baby requires a large red blood cell mass to provide sufficient oxygen for development and growth. Your baby requires iron for its own metabolic and oxygen delivery needs as well as building its own iron stores. Most of the iron is acquired in the third trimester, in preparation for the high growth rate in the first 4–6 months after birth. The late foetal and early postnatal period are recognised as a critical period where there is rapid brain development.

Those most at risk of developing anaemia during pregnancy:

  • Already having low iron levels before becoming pregnant
  • Having a pre-existing blood condition, such as sickle cell disease and thalassaemia.
  • Needing a higher demand for iron, such as having twins or triplets
  • Being under 20 years old when you become pregnant
  • Giving birth to your previous child less than 1 year ago
  • Having an inflammatory bowel disorder which affects the gut’s ability to absorb iron from food.

Symptoms of anaemia:

  • Fatigue
  • Shortness of breath
  • Heart palpitations
  • Pale skin

Blood tests for iron deficiency anaemia

  • A full blood count will be taken by your GP
  • The FBC measures many parts of your blood
  • The test checks your haemoglobin
  • Haemoglobin is the iron-rich protein in red blood cells that carries oxygen to the body
  • If a blood test shows a low red blood cell count, you'll be prescribed iron tablets.

Supplementation For Anaemia

Iron tablets replace the iron needed for haemoglobin levels to rise.

Folic acid and Vitamin C help with the absorption of iron from the gut
Once your haemoglobin is back to normal, you should keep taking the supplements for another 3 months as this helps to boost your body’s store of iron.

Foods’s high in Iron:

  • Dark-green leafy vegetables like watercress and curly kale
  • Cereals and bread with extra iron in them (fortified)
  • Meat
  • Dried fruit like apricots, prunes, and raisins
  • Pulses (beans, peas, and lentils)

Untreated iron deficiency anaemia:

  • A lack of iron affects the immune system
  • May increase your risk of developing complications that affect the heart or lungs
  • Can cause a greater risk of complications before and after birth

Balesaria, S., Hanif, R., Salama, M.F., Raja, K., Bayele, H.K., McArdle, H. & Srai, S.K.S. (2012) Fetal iron levels are regulated by maternal and fetal Hfe genotype and dietary iron. Haematologica, 97, 661– 669.
Beard, J.L., Hendricks, M.K., Perez, E.M., Murray-Kolb, L.E., Berg, A., Vernon Feagans, L., Irlam, J., Isaacs, W., Sivem, A., Tomlinson, M. (2005) Maternal iron deficiency anemia affects postpartum emotions and cognition. Journal of Nutrition 135, 267-272.
Ekiz, E., Agaoglu, L., Karakas, Z., Gurel, N., Yalcin, I. (2005) The effect of iron deficiency anemia on the function of the immune system. The Hematology Journal 5, 579–583.