Anemia during Pregnancy

An inadequate level of hemoglobin during pregnancy. Hemoglobin is the protein inside red blood cells that carries oxygen to body tissues. Common anemia’s in pregnancy include iron deficiency anemia (75 to 85% of cases) and folic acid deficiency. In addition, glucose-6-phosphate dehydrogenase (G6PD) deficiency, thalassemia and sickle cell anemia have genetic implications and should receive special evaluation.

FREQUENT SIGNS AND SYMPTOMS

  • Sometimes no symptoms are apparent.
  • Breathlessness.
  • Tiredness, weakness or fainting.
  • Paleness

Infrequent:

  • Palpitations or an abnormal awareness of the heartbeat.
  • Inflamed, sore tongue.
  • Nausea.
  • Headache.
  • Jaundice.

CAUSES

  • Poor diet with inadequate iron.
  • Folic-acid deficiency.
  • Loss of blood from bleeding hemorroids or gastrointestinal bleeding.
  • Even if iron and folic-acid intake are sufficient, a pregnant woman may become anemic because pregnancy alters the digestive process. The unborn child consumes some of the iron or folic acid normally available to the mother’s body.

RISK INCREASES WITH

  • Poor nutrition, especially multiple vitamin deficiencies.
  • Excess alcohol consumption, leading to poor nutrition.
  • Medical history of any disorder that reduces absorption of nutrients.
  • Use of anticonvulsant drugs.
  • G6PD deficiency is more common in persons of Mediterranean, African American and Sephardic Jewish descent. Sickle cell anemia is found in African Americans and in persons of Italian, Middle Eastern and East Indian descent.

PREVENTIVE MEASURES

  • Eat foods rich in iron, such as liver, beef, whole-grain breads and cereals, eggs and dried fruit.
  • Eat foods high in folic acid, such as wheat germ, beans, peanut butter, oatmeal, mushrooms, collards, broccoli, beef liver and asparagus.
  • Eating foods high in vitamin C, such as citrus fruits and fresh, raw vegetables makes iron absorption more efficient.
  • Take prenatal vitamin and mineral supplements, if they are prescribed.
  • Screening for several anemia’s, e.g., G6PD deficiency and sickle cell disease in high-risk women, should be considered prior to any attempt to become pregnant.

EXPECTED OUTCOME

Usually curable with iron and folic-acid supplements by mouth or by injection.

POSSIBLE COMPLICATIONS

  • Premature labor.
  • Intrauterine growth retardation (IUGR).
  • Dangerous anemia from normal blood loss during labor, requiring blood transfusions.
  • Increased susceptibility to maternal infection after childbirth.