Feeling sick, tired, irritable or weak during pregnancy is considered a common occurrence. Women are often told to ignore these symptoms as they are a ‘normal’ part of the hormonal and bodily changes during pregnancy. However, for one in three women, these conditions could indicate a more severe disorder: iron deficiency anaemia.
“Because the symptoms of anaemia resemble common conditions encountered during pregnancy like paleness, tiredness, fatigue and shortness of breath, most women often disregard these symptoms and think it as a normal part to carrying a baby to term,” says Dr Premitha Damodaran, Consultant Obstetrician & Gynecologist at Pantai Hospital Kuala Lumpur.
“Left unidentified and untreated, iron deficiency anaemia can lead to severe complications like miscarriage, premature delivery, low birth weight and increased maternal mortality,” she cautions during a workshop on ‘Pregnancy and Anaemia: More Common than You Think. Insights into Preserving Mother’s Healthy Glow’ organised by Merck Consumer Healthcare in May.
IT’S IN THE BLOOD
Iron comprises a vital component of our red blood cells, delivering vital oxygen through our body to ensure survival. According to Dr Premitha, women who are at risk of anaemia and considering pregnancy need to start planning and caring for their pregnancy and postpartum by taking the necessary measures to ensure that they have an optimal red blood cell count.
When the number of red blood cells falls below normal levels (< 12-15mg/dl) women are at risk of developing the most common form of anaemia – iron deficiency anaemia. This condition arises when the body lacks iron as a result of an iron-poor diet, poor absorption by the body, side effects of certain medications, genetic conditions, heavy loss of blood and pregnancy.
ANAEMIA AND PREGNANCY
During pregnancy, women require additional iron to make more red blood cells to support the nutrition and oxygen needs of themselves and their baby. It is estimated that a woman requires to approximately 50% more iron during pregnancy; increasing the daily standard requirement from 15 to 27mg/dl per day.
Unfortunately, many women begin their pregnancy without having sufficient stores of iron to meet their body’s increased demands for iron, leading to iron deficiency anaemia; which continues even after delivery.
Those who are at highest risk of iron deficiency anaemia after pregnancy include pregnant women diagnosed with iron deficiency anaemia, those who have experienced excessive blood loss during delivery, women who have experienced multiple births and those who are breastfeeding.
DIAGNOSIS OF ANAEMIA
Anaemia during pregnancy is easily established through a diagnosis process which starts by firstly determining the levels of haemoglobin in the body via a blood test. Prior to pregnancy, women are advised to speak to their doctors and assess the level of haemoglobin in their bodies.
Unfortunately, most times women only see their doctors after they are pregnant. By the time their blood test is done, most are already found to be suffering from mild anaemia.
In severe cases, medical attention is required as these groups of women are at risk of having a premature delivery and getting a baby with low birth weight.
PREVENTION AND TREATMENT
Depending on the severity and cause of anaemia, treating this condition requires little more than following your doctor’s advice and making some simple diet and lifestyle changes.
To boost iron supplies when you are trying to conceive, during pregnancy and breastfeeding, women are encouraged to increase intake of iron-rich foods such as poultry, green leafy vegetables, nuts, liver, whole grains, dried fruits such as prunes and raisins, beans, melons, seeds like sesame, and tofu.
Doctors also routinely prescribe iron supplements to treat anaemia. Patients are recommended to choose an iron formulation that their body can tolerate in order to optimizing absorption of iron into the body, this helps with reducing common side effects like constipation. Women who are at risk for anaemia can also consider choosing iron supplement with flavored coating to help mask the metallic taste.
- Ensure that your blood is healthy by conducting blood test when you plan to get pregnant, during pregnancy and four to six weeks after delivery
- To optimise the effectiveness of iron therapy, take iron, folate, copper and zinc supplements with food to reduce inhibitory effectse
- Avoid tea and coffee because they can reduce iron absorption if consumed one or two hours before taking iron supplement
- Take your calcium supplement separately from iron such as during bed time to reduce inhibition of iron absorption
- Continue to take iron-rich food and supplements until they stop breastfeeding or for 6 months after delivery