Anemia

Anemia in pregnan women

Definition of Anemia

Anemia is a condition in which the amount of hemoglobin is less than 11g in 100cc blood. A slight decrease in hemoglobin level due to the increased plasma volume starting from the second trimester of pregnancy is considered as normal. From the second trimester onwards, pregnant women with an hemoglobin level below 10.5 g / 100 cc are considered as anemic.
According to the World Health Organization data, it is estimated that more than 30% of the world population and half of the world’s pregnant women are anemic. More than one-third of women around the world have anemia. Therefore, anemia is considered as an important problem in terms of women’s health and a healthy pregnancy. Severe anemia leads to a five-fold increase in maternal mortality rate. In anemic expectant mothers, low levels of blood loss during pregnancy or birth may lead to serious consequences, such as maternal mortality due to heart failure. Anemia also increases the risk of miscarriage, preterm labor, postpartum hemorrhage and puerperal sepsis by unsettling the mother’s state of health.

Causes of anemia in pregnancy

In pregnancy, fetal development and the increase in blood volume boost the iron consumption. The need for iron increases especially in the second and third trimester. During the entire pregnancy a total of 1000 mg of iron (300 mg fetus, 50 mg placenta, 450 mg increased erythrocyte mass, 240 mg ongoing basal iron use of mother) is required. While the iron requirement is 0.8 mg / day in the first trimester, it becomes 6,3 mg / day in the second and third trimesters. The daily intake requirement is high after birth and during lactation as well. Even though the iron absorption increases in pregnancy, the dietary intake of iron is not sufficient to meet the requirement. Additional iron supplementation is required depending on the existing iron storage in the body. 

In developing countries, iron storage resides at very low levels due to nutritional deficiencies, infections and frequent and numerous pregnancies in majority of women. Unless  iron supplementation is provided to the mothers, replenishing the iron storage to reach pre-pregnancy levels takes more than two years.

The causes of iron-deficiency anemia in pregnant women:

1) Increased iron requirement: 

In pregnancy, fetal development and the increase in blood volume boost the iron consumption. Iron absorption increases especially in the 2nd and 3rd trimester of pregnancy because the dietary intake does not meet the iron requirement.

2) Insufficiency in iron storage:
  • Insufficient diet, 
  • Frequent labor and miscarriage,
  • Lack or low levels of iron storage due to frequent infections and parasitic diseases such as ancylostoma, necator and malaria, 
  • Malabsorption of iron due to intestinal disorders.

To be protected from anemia, it is important to;

  • Raise dietary awareness and diet plan,
  • Taking iron and folate supplementation,
  • Use medications regularly,
  • Control parasitic infections,
  • Perform food fortification studies.
  • Signs and symptoms of iron-deficiency anemia
  • Dizziness,
  • Fatigue,
  • Loss of appetite,
  • Digestive system disorders,
  • Weak or brittle nails,
  • Short breathing,
  • Pale palms and conjunctivas
Although the findings above may also be observed in normal pregnancies, anemia should be investigated.
 
The effects of anemia on the mother and baby

a) Effects on mothers:
  • Increased risk of disease and mortality in the infant and mother,
  • Increased risk of low birth weight,
  • Weakness in immune system and decrease in operating capacity. 

b) Effects on infants and children:
  • Deterioration in motor development and coordination,
  • Growth and developmental delay,
  • Disorder in language and school development,
  • Reduced physical activity,
  • Fatigue,
  • Attention deficit disorder and reduced defense mechanism against infections.
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