Anemia In Pregnancy: Symptoms, Causes, Effects And Treatment

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Anemia in pregnancy may affect fetal development and the normal functioning of maternal muscles and nerve cells. This blood condition occurs when the red blood cells (RBCs) count falls below normal. The RBCs contain a protein called hemoglobin that carries oxygen. Therefore, the RBCs play a vital role in supplying the mother and the fetus with enough oxygen and iron. A decrease in their count could impact this transportation (1) (2).

Anemia in expectant mothers may result in uneventful pregnancies. However, it is a modifiable risk factor; hence, timely intervention is important. Read on to know more about anemia in pregnancy, its types, causes, symptoms, treatment, and prevention.

Types Of Anemia During Pregnancy

There are about 400 different types of anemia, but the following are the most common types that may occur in pregnancy (1)(3)(4).

1. Iron-deficiency anemia

  • The baby uses maternal red blood cells for growth and development during pregnancy, especially in the third trimester.
  • The mother’s body uses the extra blood cells stored in the bone marrow before pregnancy to provide herself and the baby with nutrition.
  • Women with insufficient iron stores in the bone marrow may develop iron deficiency anemia.
  • It is the most common type of anemia in pregnancy, and approximately 15% to 25% of all pregnant women experience it.
  • A balanced nutritious diet before and during pregnancy can help replenish the iron stores in the mother’s bone marrow.

2. Folate-deficiency anemia

  • Folate (folic acid) is a type of vitamin B, which in combination with iron, helps in cell growth.
  • Insufficient folate during pregnancy can also cause iron deficiency.
  • Folic acid supplements before and during pregnancy help reduce the risk of having a baby with brain and spinal cord defects.

3. Vitamin B12 deficiency anemia

  • Vitamin B12 is essential in making protein and red blood cells.
  • Milk and eggs are examples of a few food items rich in vitamin B12.
  • Women who do not eat animal products (vegan) are more prone to develop vitamin B12 deficiency.
  • Vegans or women with severe vitamin B12 deficiency may often need to get vitamin B-12 injections during pregnancy.

4. Anemia of pregnancy

  • Pregnancy leads to an increased blood volume.
  • Therefore, more iron and vitamins are needed to make sufficient red blood cells.
  • Insufficient iron may cause anemia. However, it is not considered abnormal unless the red blood cell count falls too low.

Symptoms Of Anemia In Pregnancy

The symptoms of anemia in pregnancy often go unnoticed as they can be mild initially. However, the symptoms become more pronounced as the anemia progresses. The following symptoms may indicate the possibility of anemia in pregnant women (1)(3).

  • Paleness of skin, lips, nails, or palms
  • Tiredness or fatigue
  • Dizziness or vertigo
  • Breathlessness
  • Irregular heartbeat
  • Sore and red tongue
  • Ulcers in the mouth
  • Pins and needles (paraesthesia)
  • Altered style of walking and moving around
  • Blurred vision
  • Irritation
  • Diminished mental abilities (memory, understanding, and judgment)
  • Cold hands and feet
  • Trouble with concentration
  • Diminished taste sensation
  • Diarrhea
  • Muscle weakness

Causes Of Iron-deficiency Anemia During Pregnancy

The quality and the number of red blood cells produced by the body determine if the woman will develop anemia. During pregnancy, the plasma volume increases faster than the rate at which red blood cells are produced in the body.

The form and production of red blood cells can be affected for the following reasons, and it may lead to anemia (3).

  • A lack of iron in the diet or inability of the body to absorb iron from the consumed food.
  • Heavy bleeding due to an ulcer, a polyp, blood donation, or an injury may lead to red blood cells getting destroyed faster than the rate at which they can be replenished.
  • Pregnancy itself may cause iron deficiency anemia because the iron being produced is used by the woman’s body to increase her blood volume. Therefore, there may be less iron in the mother’s blood to supply to the developing fetus in such scenarios.

Effects Of Anemia On Pregnancy And Baby

While most pregnant women with anemia have a healthy pregnancy and deliver healthy babies, some women may have the following complications (1).

  • Premature birth
  • Low birthweight
  • Intrauterine growth restriction
  • Placental abruption
  • Problems related to blood loss during labor, postpartum hemorrhage
  • Need for transfusion of blood and blood products
  • Iron deficiency in the newborn for the first three months
  • Issues with the baby’s mental development

Mild anemia is normal during pregnancy. However, more severe anemia can put both the mother’s and child’s health at risk (5).

Risk Factors For Anemia During Pregnancy

The following factors could put a woman at a higher risk of developing anemia during pregnancy (4).

  • Vegetarian and vegan imbalanced diets
  • Celiac disease or Crohn’s disease may cause problems in absorption of iron
  • History of a weight loss surgery (a part of or the entire stomach surgically removed)
  • Shorter gaps between two consecutive pregnancies
  • Twin pregnancies
  • Frequent vomiting due to morning sickness
  • Insufficient iron and vitamins in the diet
  • Heavy periods before pregnancy

Treatment For Anemia During Pregnancy

The treatment of anemia depends on the symptoms, age, overall condition, and severity.

Treatment of iron deficiency includes taking iron supplements. Some iron supplements are sustained-release, while the others might need to be consumed several times a day. Some women with severe anemia may need a blood transfusion.

Taking iron supplements with citrus juice, such as orange juice, can help your body absorb iron better. Consuming antacids with iron supplements can make it difficult for the body to absorb iron. You must have iron supplements in the dosage prescribed by your doctor to minimize side effects such as nausea, constipation, and green- or black-colored stools (3)(4).

Prevention Of Anemia During Pregnancy

Anemia can be easily prevented by making certain changes and additions to the daily diet. The experts at the American Pregnancy Association recommend that a pregnant woman eat 30mg of iron each day. It can be achieved by consuming at least three servings of iron-rich food every day.

The following are some examples of iron-rich foods (3)(4).

  • Meat: Beef, pork, lamb, liver, and organ meats
  • Poultry: Chicken, duck, and turkey
  • Low-mercury fish: Shellfish, fully cooked clams, mussels, oysters, sardines, anchovies, salmon, shrimp, pollock, cod, tilapia, tuna, and catfish
  • Dark, leafy green vegetables: Spinach, kale, broccoli, turnip greens, collards
  • Legumes: Lima beans, green peas, dry beans, peas, pinto beans, black-eyed peas, and low-sodium canned baked beans
  • Foods rich in vitamin C: Citrus fruits, berries, kiwis, tomatoes, and bell peppers
  • Bread, pasta, rice, and cereals enriched with iron
  • Nuts and seeds
  • Black jaggery, groundnuts, dates, and figs
  • Tofu
  • Yeast-leavened whole-wheat bread and rolls

Anemia in pregnancy can be common, but it is manageable without any complications in most women. After childbirth, the blood volume and plasma levels return to normal levels. If you feel any of the symptoms that may indicate anemia during your pregnancy, it should be brought to your doctor’s notice. Eating a balanced diet and consuming prescribed amounts of supplements can help you prevent serious complications.

Key Pointers

  • Iron, folate, and Vitamin B12 deficiency anemia are the most frequent types of anemias in pregnancy.
  • A lack of iron in the diet and the pregnancy itself can cause iron-deficiency anemia during pregnancy.
  • Depending on the symptoms, age, overall health, and severity, anemia in pregnancy can be treated.
  • Consuming the recommended iron intake every day throughout pregnancy may help avoid anemia.


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Dr. Shweta Shah

Dr Shweta is a passionate and skilled gynaecologist with unparalleled experience in her field of around a decade . She herself being a woman , connects and resonates with her patients like her beloved family. She is a prolific doctor who can be related to women across all walks of life. Compassionate and warm, Dr. Shweta Shah is a patient-centric... more

Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. She also holds a certificate in lactation counselling from iNational Health... more