Anemia in pregnancy: causes, risks and management

Anemia in pregnancy – and anemia in general – is a condition caused by a low level of red blood cells that carry enough oxygen to the body’s tissues. Many women develop anemia in pregnancy because they do not have sufficient levels of iron or other important vitamins to help produce the red blood cells needed to increase blood supply.

Blood carries oxygen, and the body needs oxygen to function. During pregnancy, the amount of plasma in the body increases, as does the number of red blood cells. Anemia occurs when the level of red blood cells does not increase in accordance with the plasma.

Anemia in pregnancy is so common that pregnant women are tested from the first prenatal visit and then again, in the third trimester of pregnancy . The good news is that anemia is detected with the help of these blood tests. But, if it is not treated, anemia in pregnancy can affect the mother and the child.


  1. General information about anemia in pregnancy
  2. Causes of anemia in pregnancy
  3. Risk factors
  4. Signs and symptoms
  5. Treatment and prevention


General information about anemia in pregnancy

Anemia occurs when there are not enough red cells in the blood to carry oxygen to the body. Without enough oxygen in the blood, the body cannot function properly. A person who has anemia during pregnancy is considered anemic.

Red blood cells contain an important protein called hemoglobin. This protein retains oxygen and helps red blood cells carry oxygen from the lungs to the body. It also helps transport carbon dioxide from the body to the lungs, which is then eliminated through exhalation.

To produce erythrocytes and hemoglobin, the body needs a constant supply of iron and vitamins. Without this intake, the body does not produce enough hemoglobin to transport oxygen properly to the organs. Anemia in pregnancy is common, because pregnant women do not have enough iron and other vitamins in their blood.

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Causes of anemia in pregnancy

There are several types of anemia in pregnancy.

  • Iron deficiency anemia

During pregnancy, the baby uses red blood cells to grow and develop, especially in the last three months of pregnancy. If the mother has more red cells stored in the bone marrow before becoming pregnant, the body can use these reserves during pregnancy. Women who do not have enough iron stores can develop iron deficiency anemia. This is the most common type of anemia in pregnancy. A balanced diet before pregnancy is important to help build these iron stores.

  • Vitamin B12 deficiency

Vitamin B12 is important in the production of red cells and proteins. Eating foods of animal origin, such as milk, eggs, red meat and poultry, can prevent vitamin B12 deficiency. Women who do not consume foods of animal origin, such as vegetarians, have a higher risk of developing vitamin B12 deficiency . What’s more, women who follow a strict vegan diet often need vitamin B12 injections during pregnancy.

  • Folic acid deficiency

Folic acid is a B vitamin that works with iron to help produce blood cells. Without enough folic acid during pregnancy, women can develop iron deficiency. If administered before becoming pregnant and at the beginning of pregnancy, folic acid helps reduce the risk of having a child with certain congenital malformations of the brain and spinal cord.

Risk factors

The risk of anemia in pregnancy is higher among women:

  • vegetarians or vegans, because they have a higher risk of developing vitamin B12 deficiency;
  • who have celiac disease or Crohn’s diseaseor who have undergone stomach reduction surgery.

Also, women are more likely to develop anemia in pregnancy if:

  • they had two pregnancies at a close distance between them;
  • are pregnant with twins or more babies;
  • they often vomit due to morning sickness;
  • I don’t get enough iron from food and prenatal vitamins;
  • they had heavy periods before pregnancy.

Signs and symptoms

It is possible that the obvious symptoms of anemia in pregnancy appear only after the blood cell level drops dramatically. Symptoms that may appear are:

  • pale skin, lips, nails, palms or the lower part of the eyelids;
  • feeling of fatigue;
  • feeling of vertigo or dizziness;
  • breathing difficulties;
  • fast heartbeat (tachycardia);
  • concentration problems.

The symptoms of anemia can be similar to those of other diseases, so you should always consult your doctor for a diagnosis.

Treatment and prevention

Severe anemia in pregnancy is usually treated with blood transfusions. However, anemia is preventable, especially with a diet rich in nutrients.

Here’s how you can get the vitamins and minerals needed to keep your red blood cell levels at an optimal level.

  • Prenatal vitamins

Prenatal vitamins contain most of the micronutrients, such as iron and folic acid, that you need during pregnancy.

Take prenatal vitamins once a day to complement a healthy diet. It is ideal to start taking prenatal vitamins at least two or three months before trying to get pregnant.

  • Iron supplements

If you have a low iron level, your doctor may recommend that you take iron supplements, in addition to your daily prenatal vitamins.

In general, pregnant women need about 27 milligrams of iron daily. However, the dose may vary depending on the type of iron or the iron supplement consumed, so it is absolutely essential to discuss the necessary dose with the doctor.

You should avoid taking antacids or calcium-containing supplements at the same time as iron supplements, because they can prevent the correct absorption of iron.

  • Adequate nutrition

Most women can obtain sufficient levels of iron and folic acid during pregnancy simply by eating the right foods. Excellent sources of iron and folic acid are:

  • poultry meat;
  • fish meat;
  • lean red meat;
  • beans;
  • nuts and seeds;
  • greens with dark leaves;
  • fortified cereals;
  • fruits such as bananas and melons.

Animal sources of iron are the easiest to absorb. If the iron comes from a vegetable source, it should be paired with foods rich in vitamin C, such as tomato or orange juice, to help improve absorption.


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