Pregnancy And Iron Deficiency Anemia

Iron deficiency anemia is fairly common in pregnancy and is related to preterm delivery and the birth of small infants. In women, iron deficiency generally reduces appetite, food intake, mental alertness, and productivity. It can cause irritability, fatigue, and an increased susceptibility to infection as well. Iron deficiency anemia is especially common among women who have previously experienced it, who donate blood regularly, who habitually consume a low-iron diet, who have had a previous cesarean section, and who enter pregnancy with low iron stores.

less than 12 µg/ml). Hemoglobin levels between 10.5 and 13.2 g/dl in the second and third trimester of pregnancy are considered ideal. Levels of hemoglobin normally decrease in pregnancy due to an increase in blood volume. Among women without iron deficiencies, hemoglobin levels do not increase with iron supplements.

There is a tendency among U.S. health care providers to dispense doses of iron that are too high and cause side effects. Only 30 mg of iron daily in the second and third trimester of pregnancy is needed to prevent iron deficiency, and 30 to 60 mg per day to treat it. Women with good iron stores do not absorb as much iron from supplements as do women who need the iron. Unabsorbed iron in the gut can produce nausea, heartburn, gas, cramps, diarrhea, and constipation. Stools produced when too much iron is taken are generally tarry, dark, and dense.

Rather than take excessive levels of iron and put up with the side effects, about one-third of pregnant women will stop taking their iron pills. All too often, the leftover pills are put into a medicine cabinet and later found by curious toddlers. Iron overdose is the leading cause of poisoning deaths in young children in the United States. Use of excessively high amounts of iron in supplements can lead to another problem women may not take them even if they are needed, and so may develop iron deficiency later on or in the next pregnancy. How much better it would be if the proper amount of iron was given in the first place! Overloading women with iron in pregnancy is an out-of-date practice, one that is changing too slowly.

A new school of thought about the use of iron supplements by all pregnant women is emerging in the United States and Europe. Scientists are calling for a reexamination of the recommendation that all pregnant women receive iron. Iron supplements should be prescribed based on each woman's need for iron. Women who have a good level of stored iron and who consume iron and vitamin C-rich foods probably do not need iron supplements.

Prevention and Treatment of Iron Deficiency Anemia

The use of 30 mg of iron daily in the second and third trimester is currently recommended for the prevention of iron deficiency anemia in pregnancy. For women who have iron deficiency anemia, 30 to 60 mg of iron should be taken daily. If higher doses of iron are prescribed, a 15 mg zinc supplement and a 2 mg copper supplement should be added. The reason additional zinc and copper are needed is because of the effect of high doses of supplemental iron on zinc and copper levels. Iron from supplements is better absorbed if taken in small doses with orange or grapefruit juice several times during the day.