Iron deficiency in pregnancy

There’s nothing more exciting (or terrifying!) than seeing those two bands appear on your home pregnancy stick test. The idea of giving birth to an entire human being is overwhelming and the need to perform this miracle perfectly is often a source of anxiety to many new parents. Most pregnant women will keep close tabs on their diet and health. However, despite the growing awareness of antenatal care, not everything can go to plan.

Iron, for example, can go into deficiency during pregnancy. Its potential for deficiency is well known and frequently addressed to women who are expecting in their antenatal visits.1

It’s important to maintain healthy iron levels in the body for a healthy pregnancy. Maintaining the recommended dose of iron in your diet (NHMRC recommends 27 mg of iron per day2) is the key to avoid a deficiency. Because iron needs can vary per trimester, it’s important to understand iron requirements throughout the pregnancy period. Your doctor or midwife can help you in this process.

Why is Iron So Important in Pregnancy?

Why is it that doctors all around the world emphasize on taking oral iron supplements when you’re on your way to becoming a mother?

Iron is an all-star nutrient that makes oxygen delivery to cells around the body possible. It makes the centrepiece of haemoglobin in red blood cells and binds oxygen as red blood cells circulate.

In pregnancy, the demand for iron amplifies and the normal non-pregnant daily intake of iron may not be able to meet the new requirements. That’s why the recommended daily intake increases in pregnancy to cater the growing foetus and pregnancy demands.1

Who’s At Risk of An Iron-Deficiency in Pregnancy?

Some women are at a higher risk of having a shortage of iron in their blood than others. The risk factors that reduce iron for some of these women are completely modifiable such as poor dietary intake of iron due to strict vegan or vegetarianism.3,4

However, there are other conditions that can put a pregnancy at a greater risk of iron deficiency which might be beyond your control. These risk groups need meticulous monitoring and prompt treatment should iron levels go down.

Your doctor or midwife will assess you for these conditions. If you have any specific concerns, always write them down and make sure you discuss them with your doctor or midwife.

How is Iron Deficiency Diagnosed?

Iron deficiency can be sneaky. Because it is impossible to detect just based on how you’re feeling, they may feel like normal pregnancy symptoms. In fact, some women might not experience any symptoms until the iron deficiency has become more severe.

Generally speaking, the signs of iron deficiency can become more pronounced in pregnancy. These signs can include1,4:

  • Weakness and fatigue
  • Breathlessness on exertion
  • Headaches

The diagnosis of iron deficiency can only be made by a doctor. If you experience any of these symptoms, it’s important to check in with your physician. You will likely be asked to get some blood tests done before a full diagnosis can be made.

How Iron Deficiency is treated in Pregnancy?

The key to treatment is prevention. Women are advised to keep their haemoglobin levels at optimum levels at all times by ensuring their daily iron requirement is properly met.1,4 Iron deficiency can be avoided by taking iron-rich foods or your physician may have already diagnosed you as having an iron deficiency or significant risk factors and prescribed a therapeutic iron supplement.3,5

Common iron-rich foods include4:

  • Red meat
  • Fish
  • Lentils
  • Nuts
  • Green vegetables such as spinach
  • Iron-fortified cereals

Animal meat is richer in iron and has the haem iron subtype that is more easily absorbed and utilized by the body. Women on a plant-based diet are more vulnerable to getting an iron deficiency because the iron group found in plants is non-haem iron. Non-haem iron subtypes are less absorbable than their haem counterparts.

Treatment with Iron Supplements:

Iron supplements have become invaluable in preventing iron deficiency in pregnancy. These affordable pills may correct a diagnosed iron deficiency when taken in accordance to your doctor’s instructions.4

Before you start taking iron supplements, it’s important that you talk to your doctor about them. The absorption of iron can be affected by what you eat so try to avoid taking it with tea or coffee.

Take Care of Your Pregnancy with Iron!

A balanced, healthy and iron-rich diet is the way to go for a healthy, happy pregnancy.

If you experience any symptoms of iron-deficiency, it’s a good idea to talk to your doctor about it so that treatment, if needed, can be started as soon as possible.

References:

  1. Pasricha, S.‐R.S., Flecknoe‐Brown, S.C., Allen, K.J., Gibson, P.R., McMahon, L.P., Olynyk, J.K., Roger, S.D., Savoia, H.F., Tampi, R., Thomson, A.R., Wood, E.M. and Robinson, K.L. (2010), Diagnosis and management of iron deficiency anaemia: a clinical update. Medical Journal of Australia, 193: 525-532. doi:5694/j.1326-5377.2010.tb04038.x
  2. Iron Dietary Recommendation (v0.1). Available at: https://www.nrv.gov.au/nutrients/iron
  3. Marsh K, Zeuschner C, Saunders A et al (2009) Meeting nutritional needs on a vegetarian diet. Aust Fam Phys 8(8): 600–02.
  4. Gastroenterological Society of Australia (GESA). Iron Deficiency Anaemia. Last Updated October 2015. Available at: https://www.gesa.org.au/resources/clinical-guidelines-and-updates/iron-deficiency/
  5. Frayne, J., & Pinchon, D. (2019). Anaemia in pregnancy. Australian Journal of General Practice, 48(3), 125-129. doi:10.31128/ajgp-08-18-4664

FGC-2020-0014 - October 2020