This blog has been compiled by Komal Adhlaka, a content writer for Proactive For Her.
Women are likely to develop anaemia during pregnancy if they don't compensate for their increased nutrient requirement. Anemia is caused when the oxygen-carrying capacity of blood is reduced. That can either be due to a nutrient deficiency such as iron, vitamin B12 or folic acid, due to increased destruction of red blood cells or increased turnover of red blood cells in the body or reduced production of these cells. Clinically, anemia is most easily detected through symptoms such as fatigue, palpitations, reduced appetite, pale skin and nails. In laboratories, the easiest screening test is measuring the Hemoglobin (Hb) levels in the blood. Maternal Anemia is detected when Hb level drops below 11 g/dL. Based on severity, anemia can be classified as -
- Mild anemia: Hb between 10.9 - 10 g/dL
- Moderate: 9.9-7 g/dL
- Severe: <7 g/dL
Your body produces more blood to support the adequate growth of your baby during pregnancy. Due to deficiency of iron or certain other nutrients, the body's ability to produce enough RBCs reduces, leading to a higher risk of premature birth, low birth weight, etc.
While mild anemia is normal during pregnancy, regular guidance from your doctor, proper diet, and right nutrient intake may reduce the risk of moderate or severe anaemia or related complications during pregnancy.
Understanding the common symptoms, treatment options, foods, etc., will help you recognize your body’s suitability to different diet plans, their effects on your body and baby and may eventually lead to improving your health during pregnancy.
Causes of anemia during pregnancy
Your body uses iron to make haemoglobin, a protein in the red blood cells responsible for carrying the oxygen to your tissues. You need double the amount of iron during pregnancy than non-pregnant women to produce RBCs, which will eventually supply oxygen to your baby. If you don't have enough iron stores or get enough iron during pregnancy, you could develop anaemia. Anaemia can take different forms:
- Iron-deficiency anemia
Iron-deficiency anemia occurs when iron stores in the body reduce, leading to reduced production of haemoglobin. During pregnancy, the body doubles its efforts to provide the proper nourishment for the baby, leading to increased blood volume by about 45 per cent. Thus, making the mother vulnerable to lower Hb levels in the body. This is called hemodilution but that is not the cause of the iron deficiency. The causes of iron deficiency are inadequate stores of iron or inadequate intake or both. It can also be due to poor absorption of iron in the body. - Vitamin B12 deficiency
Vitamin B12 is found primarily in fortified foods (foods that have nutrients added to them that don’t naturally occur in the food, like milk, etc.) and animal products like meat, fish, poultry, and eggs. Women who do not consume adequate amounts of Vitamin B12 or find it challenging to process B12 may be at a higher risk of developing anemia during pregnancy. - Folate-deficiency anemia
Folate-deficiency anemia is caused due to the deficiency of folate (a water-soluble vitamin that helps prevent cognitive brain problems during pregnancy). Women need more folate content during their reproductive years and in pregnancy, which is why they're often advised to take a folic acid supplement when they're pregnant or are planning to conceive. Folate deficiency and vitamin B12 deficiency may coincide. Folate deficiency does not cause seizures, although it may involve the central nervous system, producing neuropsychiatric complications. Folate deficiency involves common antiepileptic drugs (AEDs):
- AEDs can impair folate absorption.
- AEDs, including phenytoin, carbamazepine, and barbiturates, can impair folate absorption.
Symptoms of Anemia During Pregnancy
The most common symptoms of anemia during pregnancy are:
- Pale skin, lips, and nails
- Dizziness
- Feeling tired or weak
- Shortness of breath
- Trouble focusing
- Fast heartbeat
During the early stages of anaemia, you may not have prominent or visible symptoms. And many of the symptoms are similar to those you have while you're pregnant and non-anemic. Regular blood tests to check for anemia during pregnancy may help in timely treatment.
Risks of Anemia in Pregnancy
Severe or untreated iron-deficiency anemia during pregnancy can increase your risk of having:
For baby
- A preterm or low-birth-weight baby
- A baby with anemia
- A child with developmental delays
For mother
- A blood transfusion (in case you lose a significant amount of blood during delivery
- Postpartum depression
Ways to prevent common types of anemia during pregnancy
In most cases, anemia during pregnancy can be prevented or cured, especially with good nutrition.
Here are some ways to make sure you’re getting the necessary vitamins and minerals to keep your Hb levels within the suitable range.
1. Iron supplements
Pregnant women are recommended about 27 milligrams of iron intake every day. However, the supplement dose may vary from woman to woman, depending upon other factors like diet, body metabolism, type of iron or iron supplement consumed. Hence, it’s best to talk to your doctor about the required dosage.
Factors that deter iron absorption in the body are calcium and phytates. Hence while taking iron supplements, it's important to AVOID the following -
1. Avoid taking an iron tablet with milk or tea
2. Avoid taking an iron tablet along with a calcium supplement.
3. Ensure that you have at least a gap of 2-4 hours between iron and additional medication or supplements.
4. Talk to your doctor about the best times to take your supplements.
2. Essential vitamins
Folic acid and B12 contain the required micronutrients needed by your body during pregnancy. So, it is good to take these supplements starting in the first trimester and iron in the second trimester.
These may help supplement a healthy diet for adequate red blood cell production.
- Proper nutrition- Most people can get sufficient amounts of iron and folate during pregnancy by eating the right foods. Foods rich in iron and folate are advised during pregnancy to be consumed with vitamin C and lactic acid to enhance absorption. Good sources of these include:
- Green Leafy Vegetables- Leafy vegetables like spinach, coriander or cilantro, fenugreek are rich sources of dietary iron. They also have high calcium, Vitamin B, C, and beta carotene, which are essential to maintain immunity during pregnancy.
- Beetroot- Beetroot is a superfood that one must include in the daily diet to maintain health and immunity. It is rich in iron, folate, potassium, manganese, and dietary fiber and is a good source of Vitamin C and magnesium. You can eat it raw, steamed, and make pickles or juice.
- Eggs- Eggs have vast stores of minerals, vitamin B, omega-3 fatty acids, and protein that improve overall health. Furthermore, they help in repairing and replacing the worn-out cells in the body.
- Seafood- Seafood, including shellfish and fish, have heme-iron, which is easy to absorb. Shellfish include shrimp, oysters, scallops, etc. At the same time, fish may include haddock, dried cod, etc.
- Nuts and Seeds- Peanuts and Sesame seeds are some of the richest and readily available sources of iron in Indian diets. Nuts, including walnuts, pine nuts, hazelnuts, and pistachio, are some of the best foods to combat anemia. Dried apricots, raisins, dried peaches, and dates are also excellent iron and vitamin C sources.
Quick Tip: It is recommended to roast or soak the nuts overnight before consumption. - Legumes - Legumes contain a high amount of iron. Women following a vegetarian diet will relate to the fact that soybean is an excellent alternative to fish products and red meat. Soy is high in B-vitamins, which help in the regeneration of hemoglobin and enhance the body’s absorption of iron. Chickpeas and Kidney beans are also very beneficial as they are high in magnesium, protein, zinc, and phosphorus contents.
Quick Tip: Legumes should preferably be consumed after sprouting and steaming to increase digestibility and enhance iron availability. - Fruits rich in Iron and Vitamin C- Pomegranate- Pomegranate is a rich source of vitamin C, Folate, and iron. Therefore, consuming pomegranate can be suitable for those with anemia since it enhances the absorption of iron. You could consume pomegranate as a fruit or as juice.
Citrus Fruits & Vegetables: Lemon, Guava, Oranges, Apple, Tomatoes, Amla, Berries- Fruits & vegetables rich in vitamin C are essential for iron absorption in the body. They not only enhance the bioavailability of minerals present in food but also improve overall immunity. Hence, it is strongly advised for pregnant women to include at least one seasonal citrus fruit/vegetable in their everyday meal. - Milk- Milk is an excellent source of Vitamin B12 that helps in treating/preventing anemia. Quick tip: It's better to consume milk in the form of curd, yogurt, or buttermilk as fermentation improves vitamin-b12 content and availability of other minerals in the milk. However, milk shouldn’t be consumed simultaneously with other iron-rich foods as milk is high in calcium.
- Honey & Jaggery- Adding to your wonder, Jaggery and Honey can work as perfect replacements of sugar during pregnancy to beat anemia. Unprocessed honey contains manganese, iron, and copper, which can help boost haemoglobin synthesis during pregnancy. However, sweeteners like jaggery or honey are preferably taken in moderation.
Go Easy and Slow: Simple ways of enhancing iron through regular diets.
It's perfectly okay to feel overwhelmed if you find these foods relatively new to your current dietary habits. It is suggested to go slow and start including foods that suit your taste and choices one by one. Here are a few simple and easy tips for beginning with your iron-rich diets:
1. Adding lemon juice to every meal and drinking lime water once a day is the easiest way to increase iron absorption.
2. Enhancing diversity: Try mixing vegetables like spinach with tomato or have boiled-sprouted beans salad despite taking these foods separately.
3. Easy iron-rich snacks that you can eat throughout the day (they act as a natural homemade iron supplement): Roasted peanut and jaggery powder, sesame ladoo, dry-fruits bar, or ladoo (preferably made with ghee and jaggery), etc. Care should be taken to consume these foods in moderation especially by women who are at a higher risk of gestational diabetes.
4. Importantly, during pregnancy, appetite fluctuates as well as taste buds become hypersensitive. Hence, it’s better to take small portions throughout the day rather than eating at once.
Foods to limit or avoid during pregnancy
If possible, you should limit certain foods to maintain your Hemoglobin levels, while avoiding others:
- Caffeine- Caffeine could also reduce the ability of iron absorption into your system. Thus, ardent caffeine lovers are recommended to consume less than 200 mg of caffeine which is safe. However, they must avoid consumption of caffeine within 1-2 hours of taking meals and iron supplements.
- Alcohol- Consumption of alcohol adversely affects fetal development during pregnancy. Fetal alcohol syndrome occurs in approximately 1 to 2 infants per 1000 live births in countries like the United States. Women who consume alcohol moderately may produce offspring fetal alcohol effects, or may also show a higher rate of spontaneous abortion, abruptio placentae, and having infants with low birth weight.
Final Words
If you’re pregnant or planning to become pregnant, you need to know about the significance of iron, folic acid, and vitamin B12 consumption. Preventing anemia is a significant step toward a healthy pregnancy. When you’re making a baby, you can’t ignore these essential nutrients. Follow a well-planned diet, take prenatal vitamins, and speak with your doctor if you're in discomfort or experiencing any symptoms of anemia. If you have an iron deficiency, your doctor may recommend the right course to curb it.
Disclaimer - This information is provided for educational purposes and should not be construed as medical advice. Please consult with your healthcare practitioners before undertaking any changes in your diet or adding supplements.
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