Iron deficiency anaemia in pregnancy

Anaemia is one of the most common conditions affecting pregnant Australian women; however, many are unaware of what it is or the importance of testing for the condition. Given how serious anaemia can be in a pregnant woman, it's a good idea to have some understanding of it, even if you're not yet pregnant.

Anaemia occurs when a woman has an inadequate amount of a substance called haemoglobin in her blood.  Haemoglobin is a protein that contains iron and is found in the red blood cells. It binds oxygen in the lungs and transports it around the body so cells can create energy. Anaemia is usually diagnosed by a simple blood test done as part of routine bloodwork for pregnancy. If your results indicate you have low haemoglobin, then your obstetrician will arrange further tests to investigate what the cause is likely to be.

Pregnant women may develop anaemia for several reasons. It's common to have a slight drop in haemoglobin in pregnancy, especially during the second trimester. This is because a pregnant woman's blood volume increases during pregnancy, diluting the concentration of haemoglobin in the blood. This may make you feel a little tired; however, it is a normal part of pregnancy.

Some women are already mildly anaemic heading into pregnancy, and the increased demand for iron during the pregnancy makes this pre-existing anaemia even worse. Others have low iron stores which are unable to adequately supply the extra iron needed to support a growing baby. Some women develop iron deficiency and anaemia from a poor diet, either due to lifestyle choices or difficulty eating a wide variety of foods due to morning sickness or food aversions early in pregnancy.

It's important to treat iron deficiency anaemia in pregnancy. Not only can it lead to severe fatigue, breathlessness, poor appetite and difficulty sleeping in the mother, but it also increases a baby's risk of being low birth weight or eventually being iron deficient themselves. If you have anaemia, then your recovery from childbirth will be more difficult, especially if you have a large bleed or haemorrhage following the birth.

Initially, anaemia can be treated by increasing dietary iron and taking oral iron supplements. Some supplements will be better tolerated than others, with some causing constipation and indigestion. Ask your obstetrician which are the best supplements to take for your unique situation.

If oral supplementation isn't improving your haemoglobin levels, if you're unable to tolerate the oral supplements or if it's late in pregnancy, then your obstetrician may recommend an iron infusion. This is usually done in a hospital and involves infusing an iron-rich solution directly into your veins. Your body will take up the iron from this over the next 10-14 days to improve your haemoglobin levels.

If iron deficiency anaemia is diagnosed and treated early it will have minimal impact on your pregnancy and your baby's health, so make sure to talk to your obstetrician about any concerns you may have.