Anemia – a disorder characterized by a lack of red blood cells in the blood – is among the most common ailments in obstetrics.
Due to an iron deficiency in 95% of cases, anemia is mainly manifested by fatigue, dizziness, ringing in the ears, headaches or even a pale face.
Anemia can also be caused by a deficiency in vitamin B12 and vitamin B9, or folic acid. This deficiency generally appears from the first weeks of pregnancy.
Update on received ideas with Camille Paturaud, obstetrician-gynecologist at the Kantys maternity hospital – Santa Maria polyclinic.
It is very common: true
“Many women worry about having anemia during pregnancy. In reality, it is not even a disease per se but rather a common disorder that affects a large majority of women”, reassures Dr. Camille Paturaud. In question, iron needs significantly increased.
Explanations: “The mother-to-be circulates her blood but also that of the baby. In addition, to develop, the fetus will draw on the reserves of the maternal organism”.
Throughout pregnancy, the amount of blood increases to ensure proper distribution of nutrients throughout the body.
The concentration of red blood cells – which contain hemoglobin, an iron-rich protein – will then drop, a process called “hemodilution” (because the blood cells are diluted). And it is this drop in red blood cells in the blood that creates anemia.
Iron deficiency does not lead to complications: false
Hemoglobin contains iron and allows oxygen to be transported to all the organs of the pregnant woman but also to the fetus.
This is an essential element for the smooth running of pregnancy. Also, in case of severe anemia and therefore significant iron deficiency, there is a risk of complications.
First for the mother. “During childbirth, blood loss will be less well tolerated and this may require blood transfusions.”
For the baby, a significant iron deficiency increases the risk of premature delivery but also of low birth weight. “The fetus will not have received the quantity of oxygen necessary for normal development, and in particular at the level of the brain.”
Fortunately, cases of severe anemia are very rare. “In France, women are very well monitored. Often, severe anemia concerns future mothers who come from abroad or who learned of their pregnancy late”details the gynecologist.
Anemia never starts in early pregnancy: false
Future mothers can be deficient from the 2nd trimester (the most common case), or even from the first month. A much rarer situation; “These women generally suffered from anemia before becoming pregnant and the pregnancy only accentuated the phenomenon”.
Several situations can explain this early disorder. First, heavy menstruation. “These women lose a lot of blood every month and have low iron levels.”
Anemia can also be accentuated due to insufficient nutritional intake, especially in the case of a vegan or vegetarian diet.
Another explanation: numerous and closely spaced pregnancies. “The mother’s organism does not have time to replenish a sufficient stock.”
Anemia can also be amplified in the case of multiple pregnancies (twins or triplets) because the needs increase to ensure the growth and development of several fetuses.
Blood test is the only way to detect anemia: true
“As some women have no symptoms, the only way to know if a patient is deficient is to order a blood test to check the hemoglobin level and the concentration of red blood cells”says the gynecologist.
This sample is taken every month during pregnancy.
To treat yourself, a diet rich in iron may be enough: false
As the body does not produce iron, it must be obtained elsewhere. And tapping into food is not enough.
“Because iron is present in very small quantities. You would have to eat kilos of meat, nuts or peas to restore sufficient intake.”
In case of anemia, the only solution is therefore to have a drug treatment.
From one woman to another, the treatment may be different: true
“It is extremely common to supplement a pregnant woman with iron. When this is not the case, I am even surprised”, concedes Dr. Camille Paturaud. To specify the treatment, the doctor will take into account the hemoglobin level but also the patient’s condition.
“If the anemia causes no or few symptoms, iron tablets can be prescribed to be taken every day, during meals. In general, this treatment begins in the 4th month of pregnancy and continues until the childbirth. Iron tablets may be difficult to digest and should not be taken at any time.”
If the patient has a low hemoglobin level but also significant symptoms, such as fatigue or palpitations, it is possible to infuse iron intravenously.
“This treatment is done in the hospital. The patient performs two infusions 48 hours apart for three hours.” Then iron rebalancing continues with iron tablets to be taken every day until delivery.
Anemia of pregnancy predisposes to anemia after childbirth: true
Depending on the clinical signs and the hemoglobin level, iron supplementation may be decided. A few months after childbirth, a visit to the doctor will allow the hemoglobin and ferritin levels to be checked by taking a blood sample, and the treatment to be readjusted if necessary.
What about breastfeeding?
There are no contraindications to taking iron supplements while breastfeeding. However, like all medications and supplements, they can only be prescribed when there is a real need and on prescription.
Note that even if the mother is anemic and breastfeeding, the body will adjust the amount of iron in breast milk so that the infant receives enough.
It should also be noted that exclusive breastfeeding can help the mother to prevent anemia. Indeed, menstruation is delayed and this allows the blood to be kept longer in the body.
Iron tablets: avoid taking them on an empty stomach
Taking iron tablets every morning during pregnancy can lead to gastrointestinal disorders, nausea, even constipation or, on the contrary, diarrhoea. It also happens that iron tablets color the stools black.
“Iron is not digested very well. This is why it is not recommended to take your treatment on an empty stomach. It is better to take your tablet during or in the middle of a meal to avoid side effects”advises Dr. Camille Paturaud.
It is also not recommended to consume coffee, tea or dairy products at the same time as iron supplementation. Indeed, the tannins contained in these drinks, as well as calcium, prevent the body from absorbing iron.