Anaemia is a condition in which the body does not have enough healthy red blood cells. Iron deficiency anaemia occurs when there is not enough iron in the blood. Iron is an important building block for haemoglobin, the part of red blood cells that carries oxygen.

In pregnancy, the amount of blood in the body must increase by almost 50 per cent to feed the growing baby. As a result, the mother's body starts to make blood at a faster pace. Sometimes the need for iron is greater than the amount stored in the body. The result is iron deficiency anaemia. Iron is an important nutrient during pregnancy, so it's important for an expectant mother to be sure to have an adequate intake.

According to Associate Professor Gynae Unit-1 of Civil Hospital Karachi, Dr. Lubna Ali, anaemia in pregnancy is widespread in our country and iron deficiency anaemia is the commonest type of anaemia. Iron deficiency anaemia is a leading cause of maternal mortality and perinatal mortality. Pregnant women with iron deficiency anaemia, particularly in their first and second trimesters, have an increased risk for premature delivery and for delivering a low-birth weight infant. A research shows that about 50 to 60 per cent of pregnant women in our population are affected by anaemia and about 340 out of 100,000 women die due to severe anaemic conditions.

Dr Lubna suggested that the blood iron levels of women of child bearing age should be regularly monitored and proper nutritional care should be taken to overcome this problem.

Symptoms:

The first visible symptoms of anaemia are tiredness and paleness. Also palpitations - the awareness of the heartbeat, breathlessness and dizziness can occur, though they are unusual. If the anaemia is severe (less than 6g of haemoglobin per decilitre of blood), it may cause chest pain (angina) or headaches.

Causes:

Women often become anaemic during pregnancy because the demand for iron and other vitamins is increased. In order to have enough red blood cells for the foetus, the body starts to produce more red blood cells and plasma. It has been calculated that the blood volume increases approximately 50 per cent during pregnancy, although the plasma amount is disproportionately greater. This causes a dilution of the blood, making the haemoglobin concentration fall.

Other causes may include: a diet low in iron. Vegetarians and dieters in particular, should make sure their diet provides them with enough iron. Also loss of blood due to bleeding from haemorrhoids (piles) or stomach ulcers may cause anaemia.

Risk factors:

All pregnant women are at risk of becoming anaemic. That's because they need more iron and folic acid than usual. But the risk is higher in these situations: when the woman is pregnant with more than one child; two pregnancies that are close together; excessive vomiting; the expectant mom is a teenager; the diet lacks foods that are rich in iron and heavy periods before becoming pregnant.

Avoiding anaemia

during pregnancy:

The first thing to do is to get a varied diet. If you are planning to conceive, talk to a doctor or midwife about food and supplements. Also include good sources of iron in your diet like beef, wholemeal bread and cereals, eggs, spinach and dried fruit.

A pregnant woman should take notice of her body's signals and consult a doctor if any symptoms occur. It is important to supplement your diet with iron and vitamins, especially folic acid. Foods that are rich in folic acid include beans, broccoli, beef, Brussels sprouts and asparagus. The intake of folic acid supplement helps in reducing the risk of spinal cord defects (spina bifida) developing in the foetus.

Treatment:

A doctor will examine the expectant mother and prescribe any necessary treatment for anaemia, such as vitamins or minerals. Most doctors recommend iron supplements for their pregnant patients for the first 12 weeks of pregnancy. Typically, a daily 60 milligram iron supplement is prescribed to prevent anaemia, even though the recommended amount of iron during pregnancy is 30 milligrams a day. That's because iron from supplements is not fully absorbed. Taking 60 milligrams of iron a day will ensure that you actually absorb the recommended daily amount of iron.