Anemia is a disease of the blood system associated with a decrease in hemoglobin and a simultaneous decrease in the number of red blood cells. As a result of this, the transfer of oxygen to the cells slows down, and the human condition worsens. Most often, this concept is addressed with a lack of iron in the body. According to the World Health Organization, iron deficiency anemia (or anemia) affects 29% of all women of reproductive age and 28% of pregnant women. And these indicators do not change for many years.
We will tell in our article about why anemia occurs during pregnancy, what are the symptoms of this condition and what is the danger of iron deficiency in the body for the mother and fetus. We will dwell in detail on the prevention of anemia and the principles of nutrition during the period of gestation.
Causes of Iron Deficiency Anemia
During pregnancy, not only hormonal changes in the woman’s body occur, but also a decrease in the concentration of hemoglobin in the blood. The main cause of iron deficiency anemia, doctors call an increase in the need for this trace element by almost 6 times (from 0.6 to 3.5 mg per day). This indicator exceeds the body's ability to absorb iron from food. But this element is essential for the formation of the placenta and the development of the fetus. The consequences of anemia during pregnancy can be quite serious.
In general, all the causes of anemia can be divided into three groups:
- Inadequate intake of iron in the body. Poor and unbalanced nutrition, vegetarianism, diet - all this leads to the fact that the concentration of the element in question in the body decreases sharply. Nutrition during pregnancy and lactation should be complete. High iron foods are always included in a woman’s daily diet.
- Chronic diseases of the internal organs, in particular the stomach and intestines. If the future mother has such diseases as an ulcer, gastritis with low acidity, dysbiosis, then even with a balanced and high-quality diet, a sufficient amount of iron does not enter the bloodstream.
- Frequent nosebleeds and other bleeding.
Anemia often occurs with multiple pregnancy. The need for iron in this case increases by 2 times than when carrying one fetal egg.
During pregnancy, it is quite difficult to identify the true cause of anemia, since many examinations during this period are prohibited. Therefore, the prevention and treatment of anemia should be at the planning stage of the child.
What is dangerous anemia during pregnancy?
Diagnosis and treatment of anemia is important even before conception. Then the course of pregnancy will occur with the least consequences for the baby and mother. Prolonged anemia can lead to fetal hypoxia and hypotrophy, and for a woman with low hemoglobin, the risk of blood loss during labor is increased. But this is not all that anemia is dangerous during pregnancy.
Often in the early stages of pregnancy, the symptoms of anemia do not appear. But this does not mean that such a condition is safe. Even with mild anemia of pregnant women, the fetus suffers from a lack of oxygen. And this, in turn, is fraught with a delay in fetal development and insufficient intake of nutrients to the placenta.
Anemia usually occurs in the second half of pregnancy, approximately between 29 and 36 weeks. At this time, the need for iron, necessary for the production of hemoglobin, grows several times. In addition, the volume of circulating blood in the body of a woman increases, she liquefies, which leads to a decrease in the number of red blood cells.
So, what is dangerous anemia for the mother:
- the occurrence of toxicosis of the second half of pregnancy;
- risk of premature birth;
- heavy bleeding during childbirth as a result of impaired coagulation;
- decreased milk production during lactation.
With anemia of the mother, the child does not receive enough oxygen and the necessary nutrients for it to grow and develop. As a result of this, it can be born of low weight and with a weak immune system. Such children are more prone to colds and infectious diseases.
Signs of Anemia during Pregnancy
In women carrying a child, the symptoms of anemia practically do not differ from those in other people. In addition, all the signs below can be observed in absolutely any pregnant woman. This is due, first of all, to the fact that the risk of developing iron deficiency exists in every expectant mother, and he especially increases in the second and third trimesters. But a final diagnosis of grade 1 anemia during pregnancy, second or third, is possible only on the basis of the results of a blood test.
How, by external signs, to reveal anemia in a future mother? To do this, you need to know that the main symptoms of anemia during pregnancy are:
- pale color of the skin and mucous membranes, which can be caused by oxygen starvation of tissues;
- muscle weakness and excessive fatigue, which is associated with a decrease in the amount of energy in the body;
- dizziness and fainting;
- drowsiness, depression;
- agitation and insomnia;
- decreased muscle tone;
- headache accompanied by tinnitus;
- dryness and increased peeling of the skin;
- the appearance of cracks on the lips and wounds in the corners of the mouth;
- dryness, brittleness and hair loss;
- a change in taste preferences for the worse (the desire to eat chalk, earth or soap is not the norm);
- predisposition to infections of the genitourinary system, pain during urination, urinary incontinence.
The expectant mother should pay attention to the appearance of those signs that she had never seen before. And do not immediately connect them with the "quirks" of the pregnant woman. It will be much more competent to consult a doctor and get recommendations from him regarding further actions.
Depending on the general health status of the expectant mother, the type and degree of the disease and its stage, the symptoms of anemia may vary. Details are provided below.
Who is at risk?
Studies to determine the level of hemoglobin in the blood are performed in the first and second trimesters. According to the results of analyzes, future mothers are identified, who are at risk for anemia. During pregnancy, if a hemoglobin deficiency was detected in the first trimester, preventive measures are prescribed to the woman. The final diagnosis and the need for complex treatment are determined in the second trimester, after re-passing the blood test.
The risk group for iron deficiency anemia during pregnancy includes:
- Women from families with low socio-economic status. As a rule, their nutrition is inferior and unbalanced, with insufficient iron content, resulting in a decrease in hemoglobin in the blood.
- Vegetarianism, dieting for the purpose of losing weight very often lead to anemia during pregnancy.
- Chronic diseases in the history of the expectant mother (diabetes, gastritis, heart defects).
- Infectious diseases of the kidneys, liver and other organs transferred during pregnancy (viral hepatitis, acute pyelonephritis, etc.).
- Various bleeding with uterine myoma, endometrial polyps, etc.
- Women who have given birth to four or more children. For them, this condition is inevitable.
- Often giving birth to women. The risk group includes expectant mothers in whom repeated pregnancy occurred earlier than 4 years after the previous birth. After pregnancy and lactation, the body needs at least 2.5 years to recover. If this period is not maintained, chronic anemia occurs.
- Women who have been diagnosed with anemia in previous pregnancies.
- Pregnancy at the age of less than 18 and older than 30 years.
- The hemoglobin level in the first trimester of pregnancy is 120 mg / l or lower.
- Complications during a real pregnancy, such as toxicosis, viral diseases, the threat of miscarriage.
- Multiple pregnancy. In this case, anemia is almost always diagnosed, since iron is needed 2 or 3 times more than when carrying one fetus.
- Polyhydramnios.
Diagnosis of anemia during pregnancy
The determination of hemoglobin level is one of the mandatory studies during pregnancy. This indicator is determined by the results of a general blood test. And on its basis, the doctor can make the final diagnosis of iron deficiency anemia and determine the degree of the disease. In addition, the trimester during which the analysis was performed is taken into account.
In the early stages, the doctor can make such a diagnosis with a hemoglobin level below 110 mg / l. If the result of the analysis of a woman is close to this indicator, the gynecologist diagnoses mild anemia during pregnancy.
In the second trimester, a critical value for diagnosis is 105 mg / L. In addition, the attending physician may prescribe additional studies of the volume of circulating blood. In particular, erythrocyte hypochromia and serum iron levels are determined. This will allow the doctor to develop the right tactics for the treatment of anemia and avoid the negative effects of the disease on the mother and fetus.
Types and degrees of anemia
To understand how severe the condition of the pregnant woman is, and to determine the need for treatment of the identified disease, it should be understood what exactly happens in the body of the woman during the period of gestation. Depending on this, 2 types of anemia are distinguished during pregnancy:
- Physiological, or gestational. From the middle of the second trimester, this condition develops in almost every pregnant woman. It is associated with an uneven increase in plasma volume and red blood cells. Often treatment in this situation is not required.
- True Such anemia occurs in 90% of pregnant women. In this case, there is a decrease in the number of red blood cells and a decrease in hemoglobin in each of them.
There are 3 degrees of anemia during pregnancy:
- Grade 1 is a mild form of anemia in which the hemoglobin level is 110-91 mg / L. It often proceeds without any signs. It is important to timely identify the lack of iron at this stage in order to take timely measures and prevent the development of the disease to more severe forms. This condition is diagnosed in a laboratory, according to the results of a general blood test.
- Degree 2 - anemia during pregnancy occurs in moderate or moderate form. Judging by the results of the analyzes, the hemoglobin level at this stage is 90-71 mg / l. The second degree of iron deficiency anemia is accompanied by certain symptoms, which is explained by oxygen starvation of tissues. A pregnant woman has weakness, drowsiness and fatigue, headaches, decreased concentration, irritability.
- Grade 3 is a severe form of anemia. The hemoglobin level in this disease is 70-40 mg / L. Symptoms of this degree coincide with the main signs of the disease described above in the article, but they manifest themselves more clearly. In contrast to anemia during pregnancy of the 1st degree, moderate and severe forms pose a real threat to the life and health of the woman and the fetus.
The consequences of anemia for mother and baby
Low hemoglobin in the blood negatively affects the health status of a pregnant woman and negatively affects the development of the fetus. Often the effects of anemia during pregnancy are irreversible.
For a woman, anemia is dangerous because it can lead to the development of one or a whole group of the following conditions:
- the formation of placental insufficiency;
- placental abruption;
- premature birth;
- weak labor activity;
- bleeding during delivery;
- increase in blood pressure;
- the occurrence of late toxicosis (gestosis), which is a consequence of a violation of protein metabolism.
- postpartum complications, weakness, decreased immunity;
- weak lactation, insufficient amount of milk produced;
- the development of purulent-septic complications in the postpartum period.
But the negative effects of anemia are reflected not only in the mother. They are also dangerous for the fetus. The following consequences of anemia during pregnancy for a child are distinguished:
- intrauterine hypoxia - the child does not receive the oxygen that he needs for the proper formation of all organs and systems;
- retardation or arrest of fetal development;
- the development of iron deficiency anemia in a newborn;
- poor weight gain due to insufficient nutrient intake.
Iron-deficiency anemia during the period of bearing a baby is a dangerous disease that requires increased attention from a woman and a doctor. And it is not always possible to raise the level of hemoglobin only by adjusting the diet. Often, more serious medication is required.
Pregnant nutrition with a lack of iron in the body
The daily human need for this trace element is 15-20 mg, of which only 5-10% is absorbed by the body. And only with pregnant anemia, the absorption of iron from products rises to 25% and is 2.5 mg. Although this is very small in comparison with the needs of the body in a special period.
Iron enters the body from products in two forms:
- Haem. It is found in products of animal origin, which include meat, poultry, fish, eggs. The absorbability of iron from them is quite high and just makes up those very 25%. Most iron is found in beef, lamb, turkey, rabbit, beef tongue. The concentration of this trace element is high in cod liver, pink salmon, seafood, pork and beef liver. These products are recommended to raise the level of iron with mild anemia during pregnancy.
- Unskilled. His body receives from plant products, which form the basis of the pregnant woman’s diet. Such iron is absorbed much worse, only 3-5%. The absorption of trace elements from such products is recommended to increase with the simultaneous intake of vitamins C and B12. Iron is found in herbal products such as buckwheat and oatmeal, asparagus, spinach, green peas, legumes, nuts, pomegranate, and corn.
The diet of a pregnant woman should be full and varied. And this means that it should include dairy and sour-milk products, eggs, cheese, fresh vegetables and fruits. A balanced diet is needed from the first weeks of pregnancy.
Anemia Treatment
The need of a woman's body for iron during gestation increases several times. But it is impossible to fill the deficiency of this microelement only with high-quality, full-fledged and balanced nutrition. The body assimilates about 2.5 mg per day, while the need for it is much higher. At the same time, the absorption of trace elements from special medicines is 15 times higher. If a woman is diagnosed with grade 1 anemia during pregnancy, you can try to raise the level of iron in the blood by adjusting the diet. If the form of this disease is moderately severe or severe, foods, vitamin complexes and folk remedies in this case will not help. You can cure anemia during pregnancy only with special drugs.
Depending on the degree of the disease and the condition of the pregnant woman, the doctor prescribes medications intended for oral or intramuscular (intravenous) administration.
The first group includes medicines containing ferrous salts (Sorbifer, Totem, Ferronate, and others) and ferric (Maltofer, Ferlatum). All of the above medicines are intended for oral administration.
What is the difference between these drugs? Ferrous salts easily penetrate the body, are well absorbed, but their administration is often accompanied by side effects. These include constipation and negative reactions from the organs of the gastrointestinal tract. Medicines containing ferric salts do not cause such side effects, but they are also absorbed worse by the body. Regardless of the drug taken, it is not so easy to raise the level of hemoglobin in the blood. It may take more than one month to increase its concentration in the blood.
Much faster iron deficiency in the body is compensated for by intravenous or intramuscular administration of drugs. As a rule, such emergency therapy is prescribed in the last stages of pregnancy and before the upcoming birth, in order to prevent the development of negative consequences in the process of childbirth and after them.
Iron deficiency prophylaxis
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