Chief pathologist and general manager National Technical Operations, Metropolis Healthcare Ltd., Dr Rajesh Bendre, tells us what it means to be anaemic, and exactly how to take care of yourself, especially during your pregnancy
Women developing anaemia during their child-bearing age, is a common phenomenon. In most cases, deficiency of iron is the primary cause of anaemia during pregnancy. It accounts for almost 80 per cent of the cases. Other factors resulting in anaemia could be lack of folic acid or vitamin B12, which can cause blood loss. Certain diseases or genetic disorders, like sickle cell disease or thalassemia, could also be the causes of anaemia in certain rare cases.
During pregnancy, the risk factors for anaemia are considerably high. Proper mitigation of these risks can ensure that the mother and the baby are in good health. It is advisable to consume a wide variety of whole foods during pregnancy. Mild anaemia is normal during pregnancy due to an increase in blood volume. In case the mother suffers from severe anaemia, the baby can have a tendency to develop anaemia in the later stages of infancy. In addition, if the mother is severely anaemic during the first two trimesters of pregnancy, then it may result in a pre-term delivery for the mother or lead to Low Birth Weight (LBW) in the baby. Anaemic pregnant women have an increased risk of blood loss during labour, making it more difficult to fight infections in the post-pregnancy period. In both, developed and developing countries, women are prone to anaemia during pregnancy. The prevalence of iron defi ciency is far greater than the prevalence of anaemia since iron defi ciency (low serum ferritin and sparse or absent stainable iron in bone marrow) often develops during the latter stages of pregnancy. On account of such findings, there is uncertainty about whether routine iron supplementation for pregnant women is necessary.
A woman is at a higher risk of anaemia during pregnancy if she:
♦ Becomes pregnant consequently within a short span of time.
♦Is pregnant with more than one child.
♦Vomits frequently due to morning sickness.
♦Does not consume
♦Has a heavy pre-pregnancy menstrual fl ow.
Many of the symptoms of anaemia during pregnancy are also symptoms that women may experience even if they are not anaemic, such as:
♦ Feeling tired or weak.
♦ Progressive paleness of the skin.
♦ Rapid heartbeat.
♦ Shortness of breath.
♦ Trouble in concentrating.
Doctors typically perform several tests to check the percentage of red blood cells in the mother’s plasma, and the amount of haemoglobin in the blood. Such tests lend insight into whether the mother has a high risk of anaemia.
The tendency to develop anaemia, signifi cantly, depends on the number of red blood cells that are being produced in the body. A noticeable fall in the haemoglobin levels during pregnancy, is caused by an extensive increase in the volume of plasma cells, as compared with the count of the red blood cells. This imbalance between the rates of increase in plasma and that of red cells (or erythrocytes) is at a peak during the second trimester of pregnancy. Regular tests during this period are medically advised.
Dangers of anaemia
The greatest physical danger associated with anaemia, is the mother’s inability to cope with blood loss during birth. In addition to increased blood loss, if the mother’s body has a deficiency of iron, it can result in reduced oxygen flow throughout the body. Hence, early diagnosis of anaemia is of paramount importance, so that the body can be fortified with the necessary iron supply, in time. Haemoglobin levels are reported to return to normalcy within five to 12 weeks, post pregnancy. In cases of extreme blood loss and lower iron content in the body, this process can take longer than usual. Breastfeeding can additionally further deplete the iron content of the mother’s body. In such cases, women are prescribed iron tablets for several weeks after pregnancy, to mitigate the loss. Having low haemoglobin can also increase the risk of depression in mothers.
Tips to prevent anaemia
In order to prevent the risk of anaemia during or after pregnancy, women must:
♦ Consume iron-rich foods such as meat, chicken, fish, eggs, dried beans and fortified grains. The form of iron in meat products, called heme, is more easily absorbed than the iron in vegetables. If you are anaemic and you ordinarily eat meat, increasing the amount of meat you consume is the easiest way to increase the iron your body receives.
♦ Eat foods that are rich in folic acid, such as dried beans, dark green leafy vegetables, wheat germ and orange juice.
♦ Eat foods high in vitamin C, such as citrus fruits and fresh, raw vegetables.
♦ Cook in cast iron pots to add up to 80 per cent more iron to the food.
♦ Take prenatal multivitamins and mineral pills, which contain extra folate.
Once diagnosed, anaemia can be easily cured. In most cases, with the right treatment, the newborn will develop a normal haemoglobin count within a couple of months. It is important to keep track the factors that caused the anaemia. In case of iron defciency in the child, parents must ensure that dietary supplements or natural iron-rich foods are provided until deemed no longer necessary by the doctor. | MB