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Iron Deficiency Anemia in Pregnancy

Although pregnancy is something that many women desire and plan, some health problems arise in the course of pregnancy. Iron deficiency anemia is one of them and can appear when you are pregnant.

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Iron deficiency anemia is caused by lack of iron and its symptoms include lack of energy, tiredness, extreme weakness, heart palpitations, dizziness, shortness of breath, trouble concentrating. All pregnant women in the UK are offered a blood test for iron deficiency anemia.

Why is iron deficiency anemia in pregnancy dangerous and should be treated?

Red blood cells carry oxygen but when you are pregnant and have iron deficiency anemia, you don’t have enough red blood cells to carry oxygen to your baby and your own tissues.

In addition, in pregnancy you need iron to produce more blood to sustain the growth and development of the baby and therefore iron deficiency is detrimental to the baby’s growth and development.

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Iron deficiency in pregnancy could cause complications before and after birth including miscarriage, preterm delivery, postpartum depression, a low-birth-weight baby, even infant death or a baby with anemia or with developmental delays.

Anemia in early pregnancy is especially harmful as it might increase the probability of having a child with intellectual disability, autism or attention deficit hyperactivity disorder (ADHD). . Among more than 500,000 children, those whose mothers had anemia within the first 30 weeks of pregnancy had increased risk of autism spectrum disorder (odds ratio 1.44, 95% CI 1.13-1.84), intellectual disability (OR 2.20, 95% CI 1.61-3.01), and attention-deficit hyperactivity disorder (OR 1.37, 95% CI 1.14-1.64) after adjustment for covariates, reported Renee Gardner, PhD, of the Karolinska Institutet in Stockholm, Sweden, and colleagues.

If you are diagnosed with iron deficiency anemia in pregnancy, your GP will prescribe iron tablets/ferrous sulfate to take to try and restore your iron stores. This will be followed up with another blood test to check if your iron stores are improving or not.

Iron tablets could have side effects including constipation or diarrhoea, feeling sick, black stools, tummy pain.

It is sensible to eat iron-rich foods in pregnancy in addition to taking those iron tablets prescribed by the GP if you have been diagnosed with iron deficiency anemia in pregnancy.

What are good sources of iron in pregnancy?

It is important to differentiate between two forms of iron-heme iron and non-heme iron.

Non-heme iron comes from plant sources such as grains, nuts and seeds and is less well absorbed by human bodies than heme iron that comes from animal sources such as meat, poultry and seafood.

In addition, dairy, milk and eggs contain non-heme iron just like plant sources of iron despite containing animal protein.

It is important to differentiate between heme and nonheme iron because around 15-35% of heme iron is absorbed from animal based sources of iron and only 2-20% of non-heme iron from plant based sources of iron.

That is not to say that one should ignore non-heme sources of iron and eat only food rich in heme iron. There are many non-heme iron foods and therefore they make up a higher contribution to iron stores in the body. Even if you choose to concentrate on heme iron foods approximately 50% of the iron from heme iron foods is still non heme.

Let us now have a look at more sources of iron.

Iron-rich foods containing mostly non-heme iron are nuts, seeds, pulses(beans, peas, chickpeas and lentils), olives, dark leafy vegetables such as broccoli and spinach, beetroot, watercress, kale, cabbage, mushrooms,dried apricots, dates, prunes, raisins, figs, watermelon, eggs, tofu.

If you eat raw spinach, iron absorption is blocked by oxalates.

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Iron-rich foods which contain heme-iron are red meat, poultry, seafood, fish, liver products.

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It is important to note however that although liver and liver products are high in iron they must be avoided by pregnant women because of their high vitamin A content which can be harmful to an unborn baby.

What decreases iron absorption

When eating iron-rich foods, tea, coffee,milk,dairy and wholegrains(contain phytic acid) should be avoided because they stop your body absorbing iron from iron-rich foods and your iron pills.

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One way to deal with this is to drink tea or coffee 2 hours after you took your iron pills or had an iron-rich meal.

What increases iron absorption

To increase iron absorption by the body, it is recommended to include foods high in vitamin C into your meals. Try combining iron-rich foods with vitamin C rich foods to maximise iron absorption.

Foods rich in vitamin C are tomatoes, bell peppers, strawberries, kiwi, citrus fruit and citrus juices such as orange or clementine juice.

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You can have them incorporated in your iron-rich meal to maximise iron absorption in pregnancy.

Prenatal vitamins for pregnant women

Prenatal vitamins for pregnant women is a good way to make sure you get all your nutrients in addition to following healthy eating, and the sooner you start taking them the better it is especially if they contain enough folic acid and other vital nutrients for pregnancy.

However, not all prenatal vitamins contain the recommended daily allowance (RDA) of iron (27 mg/day). For instance, Pregnacare vitamins contain 17mg of iron which is 10mg lower than the recommended daily allowance!

Women with chronic illnesses, intestinal disorders where absorption of nutrients is impaired as well as vegetarian and vegan women are at higher risk of iron deficiency anemia.

It is worthy to note that the information contained in this article can be of use to anybody who has been diagnosed with iron deficiency anemia although this particular article concentrated more on iron-deficiency anemia in pregnancy.

Stay healthy!

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