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You made it through the challenges of getting pregnant and are counting down the weeks and months until you get to hold your precious little one!
But now you’ve encountered a new challenge: anemia of pregnancy.
You may be feeling overwhelmed by this pregnancy complication. But the truth is that having anemia in pregnancy is actually fairly common.
In fact, nearly 37% of pregnant women around the globe are impacted by anemia. And in general, anemia touches more than 500 million female lives worldwide.
When it comes to your health and pregnancy though, we know that knowledge is empowerment. So keep reading to learn all you need to know about anemia and pregnancy and what you can do to manage it!
Key Takeaways
- Anemia happens when you don’t have enough red blood cells.
- Pregnancy can trigger anemia because of the rapid increase in your blood volume. It can also come about from iron deficiency, folate deficiency, or B12 deficiency.
- You’re more likely to develop iron deficiency anemia or other types of anemia if you have a poor diet, a multiple pregnancy, or short spacing between pregnancies.
- Anemia symptoms can look like fatigue, paler skin, rapid heartbeat, and craving for ice.
- To get an anemia diagnosis, you’ll need to get a blood test. It’s called a CBC, and it checks your hemoglobin, red blood cells, and nutrient levels.
- Mild cases of anemia during pregnancy typically don’t have a big impact on mom or baby. But severe anemia (with hemoglobin less than 6 g/dL can bring about risks like preterm birth or miscarriage.
- More mild cases of anemia are managed with iron supplements and prenatal vitamins. But severe anemia may require more serious intervention like a blood transfusion.
- The best way to prevent anemia is making sure to adopt a nutrient-rich diet. You’ll especially want to focus on getting enough iron, folate, vitamin C, and vitamin B12.
What Is Anemia?
Without going into a full-blown biology lesson, anemia is a condition where your blood doesn’t have enough number of red blood cells.
Having less red blood cells than you should can be problematic for two major reasons.
First, it keeps your organs and bodily tissues from getting adequate oxygen. And second, if you’re pregnant, it means your baby won’t get as much oxygen as they should be getting.
What Causes Anemia in Pregnancy?
There are actually 4 different ways you can develop anemia during your pregnancy.
1. Physiological anemia of pregnancy
This is also called dilutional anemia, and it can develop simply from normal physiological changes of pregnancy. (Even in a “normal” pregnancy).
Here’s how this happens:
When you become pregnant, nearly every organ system in your body undergoes changes to support the developing fetus. This includes your hematologic system.
The hematologic system plays a huge role in oxygen transport, blood clotting, proper immune function, and helping maintain homeostasis. One of the major changes that affects this organ system during pregnancy is a huge increase in blood plasma volume.
The issue that can unfold is that the volume of red blood cells doesn’t always increase proportionally with the amount of blood. And this leads to some pregnant women developing dilutional anemia.
As far as anemia of pregnancy goes, this type is considered more mild with hemoglobin values around 10 – 11 g/dl.
But since hemoglobin and hematocrit values vary so much with physiologic anemia, it’s actually pretty hard to tell this type of anemia from other types. And if you have any of the following deficiencies prior to pregnancy, you’re more likely to develop anemia once pregnant.
2. Iron deficiency anemia
You may be more familiar with iron deficiency anemia as it’s the most common cause of anemia in pregnant women. In fact, 75% of pregnancies that experience anemia are from iron deficiency.
So, why is this type so common?
For starters, iron plays a major role in some pretty powerful cellular functions. It helps carry oxygen through your entire body and also supports electron transport and enzyme function.
And once you become pregnant, your body requires even more iron to successfully carry out these functions. This is because it’s needed to maintain healthy function not only for the mother but also for the growing fetus.
The reality is that lots of women are barely getting enough iron as is. So once you throw extra iron demands for pregnancy on top, it can lead to deficiency rather quickly.
Think of it like this.
Your boss asks you to take on more projects at work. But they didn’t hire an assistant to support you with the workload. You’d be burnt out pretty quickly, right? This is pretty much what happens with iron. The demand for it increases, but the supply doesn’t match that demand.
3. Anemia from vitamin B12 deficiency
Vitamin B12 is important for red blood cell and DNA production. On top of that, it also helps with nerve function and cell metabolism.
So what happens when you have lower-than-optimal vitamin B12 levels? It can lead to anemia and impact proper fetal growth—even brain development.
What leads to vitamin B12 deficiency in the first place? The leading causes of this vitamin B12 deficiency are a diet low in foods derived from animals and absorption issues.
4. Anemia from folate deficiency
You’ve likely heard of the importance of folic acid (folate) in pregnancy. It’s known for helping prevent neural tube defects.
But folic acid (aka vitamin B9) works alongside vitamin C and vitamin B12 to support vital functions like producing red blood cells and synthesis of DNA.
How do you become deficient in folic acid and develop folate-deficiency anemia?
- Not getting enough of it from your diet
- Poor absorption
- Interference from taking other drugs or supplements
- Having an increased physiological demand (as you would during pregnancy)
Who’s at Risk for Anemia During Pregnancy?
You can be more susceptible to developing anemia during pregnancy if you:
- Follow a vegetarian/vegan diet or have low meat intake (this makes you more likely to have vitamin B12 deficiency)
- Have a diet low in essential vitamins and nutrients
- Have Crohn’s disease or celiac disease (these conditions lead to struggles with absorbing nutrients)
- Have a twin or multiple pregnancy (your demand for iron increases way more)
- Having pregnancies close to each other ( your body has less time to recuperate its diminished nutrient stores)
- Experience severe morning sickness (it makes it harder for you to keep foods down that contain important vitamins like B12 and folic acid)
- Used to experience heavy menstrual flow prior to pregnancy (this can lead to a greater risk of iron deficiency)
Resonate with any of the above descriptions? No need to panic! Whether you’re currently pregnant or trying to conceive, it’s a good idea to check in with your healthcare provider.
And keep reading to learn how you can spot potential signs of anemia!
Symptoms of Anemia During Pregnancy
Already pregnant and curious if any of your symptoms could point to anemia?
Here are some of the most common symptoms to know about:
- Extreme tiredness
- Skin that seems to be getting paler and paler
- Rapid heartbeat
- Feeling short our out of breath
- Not being able to concentrate
- Dizziness
- Craving ice (a sign of iron-deficiency)
- Sores in your mouth (a sign of vitamin B12 deficiency or folate deficiency)
- A sensation of pins and needles (vitamin B12 or folate deficiency)
Now, keep in mind that these symptoms alone don’t officially diagnose you with anemia. An official diagnosis requires a blood test, which you’ll learn more about next!
How Is Anemia During Pregnancy Diagnosed?
To see if you actually have anemia or not, you’ll need to get a blood test called a CBC (complete blood count).
A CBC panel will give you a picture of your:
- Hemoglobin (the protein in your blood cells that carries oxygen)
- Red blood cell health (the size, shape, and number of red blood cells you have which helps diagnose the type of anemia)
- Iron levels (a serum ferritin concentration less than 30 μg/L is a sign of iron-deficiency anemia)
- Levels of vitamins B12 and B9
When it comes to diagnosing anemia, a key factor is how far along you are in your pregnancy.
Below are the hemoglobin values that would officially diagnose you with anemia from the first trimester through postpartum:
Trimester | Hemoglobin levels in g/dL |
1st trimester | <11 |
2nd trimester | <10.5 |
3rd trimester | <11 |
Postpartum | <10 |
Let’s say you do get diagnosed with anemia during pregnancy, what can happen from there? Keep reading to find out!
What Are the Complications of Anemia During Pregnancy?
Having anemia while you’re pregnant doesn’t always lead to tons of extra complications. (So go ahead and take a quick sigh of relief.)
For example, if you have a mild or moderate iron deficiency, it usually doesn’t have a big impact on hemoglobin concentration for the fetus.
That said, more severe anemia (<6 g/dL) can potentially lead to some more concerning issues like:
- Premature birth
- Placenta previa (where your placenta blocks the cervix either partially or fully)
- Spontaneous miscarriage
- A low birth weight baby
- Fetal death
Of course this may feel alarming, especially if you’re already pregnant and have been diagnosed with anemia. But the good news is that anemia can be treated.
In the next section, you’ll learn the two main ways that anemia is managed in pregnancy.
How Do You Treat Anemia During Pregnancy?
If you develop anemia while pregnant, your treatment plan will depend on how severe your anemia is. But there are really only two main pathways for treatment.
If you have mild to moderate anemia, your healthcare provider will encourage you to take a daily prenatal vitamin as well as an additional iron supplement.
If your anemia is more severe, you may need to get a blood transfusion. If you’re still TTC or earlier on in pregnancy, you may be wondering how you can prevent anemia. Get this question answered next!
Can You Prevent Anemia During Pregnancy?
Thankfully, making intentional decisions about your diet can lower your risk of anemia during pregnancy.
Here are some changes to consider:
1. Eat iron-rich foods that boost your iron stores.
This includes foods like meat, fish, poultry, legumes, dark green leafy vegetables, and foods that are iron-enriched. (Sometimes products like pasta, rice, and cereal are fortified with iron.)
2. Consume vitamin-rich foods that help with iron absorption.
Foods that are high in vitamin C are great for this! Think: citrus fruits, peppers, and tomatoes.
3. Boost your folate intake.
You can do this by taking a folic acid supplement (aim for at least 400 micrograms) and also by eating foods high in folate. Some folate-rich foods include: Leafy greens, berries, citrus fruits, dried peas and beans, and fortified cereals and grain products.
4. Get plenty of vitamin B12 from your diet.
You can get this important vitamin from dairy, eggs, fish, and animal meat. If you’re vegan or vegetarian, talk to your doctor about vitamin B12 supplementation!
FAQs
Treatment for pregnancy anemia will depend on how severe your case is. So if you suspect you have it, definitely check in with your doctor ASAP. If it’s a more moderate case, taking a daily prenatal and an iron supplement is usually recommended. But if it’s more severe, sometimes a blood transfusion is necessary.
Having low iron while pregnant can bring on a range of symptoms. Some include fatigue, dizziness, and shortness or breath. It can also lead to rapid heartbeat, paler skin, difficulty concentrating, or even odd cravings (like ice).
In mild or moderate cases of anemia, the fetus is usually not impacted much, if at all. But in more severe cases, they can be. Some of the possible complications that can arise include placenta previa, preterm birth, or miscarriage.
It all depends on how extreme your anemia is. If your hemoglobin levels are less than 6 g/dL, that would be considered more severe and riskier for you and your baby. But if it gets to that point, getting a blood transfusion can help.
Was this article helpful?
Physiology, Maternal Blood – StatPearls – NCBI Bookshelf
Iron Deficiency in Pregnancy – PMC
Anemia in Pregnancy – SIFAKIS – 2000 – Annals of the New York Academy of Sciences
Maternal Vitamin B12 Status during Pregnancy and Early Infant Neurodevelopment: The ECLIPSES Study
Folic Acid Deficiency – StatPearls – NCBI Bookshelf
Diagnosis and treatment of iron deficiency anemia during pregnancy and the postpartum period
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