Anemia During Pregnancy

The term anemia refers to a lack of satisfactory red blood cells.  Red blood cells are important in the transportation of oxygen throughout the body.  Anemia during pregnancy is diagnosed when the hemoglobin level is less than 11.  Anemia is a common problem during pregnancy, occurring in up to 50% of all women.

Anemia may occur as the pregnant woman’s amount of blood increases during the second trimester.  In addition, diets low in iron or folic acid, closely spaced pregnancies or twin pregnancies may contribute to anemia.

Mild anemia does not pose a significant risk to the developing baby.  Treatment is indicated, however, to prevent anemia from becoming severe, which could harm the fetus.  In addition, treatment of mild anemia will protect the mother from side effects related to blood loss during childbirth.

Most anemias are caused by iron deficiency.  The treatment is increased dietary intake of iron and iron supplementation by pill.

Although dietary sources of iron alone will not correct anemia, iron is best absorbed from food.  Iron from animal foods is better absorbed than iron from plant or enriched foods.  Eating foods high in Vitamin C (e.g., citrus fruits and juices) along with a meal high in iron will help iron absorption from the intestine.  Coffee and tea decrease the amount of iron absorbed, as do foods high in fiber.  Refer to the list on the bottom of this card for sources of iron-rich foods.

We recommend the following treatment for anemia:

Ferrous Sulfate 325 mg

It is recommended to take Ferrous Sulfate 325mg every other day, in addition to the prenatal vitamin.  “Generic” preparations of iron will be the least expensive.  “Brand-name” iron preparations may have appealing features but are not necessary unless you are having side effects; for instance, Ferro-sequels include an ingredient to prevent constipation, Ferancee-HP contains Vitamin C to enhance absorption, and Slow-Fe is time-released to help prevent stomach upset.  Most iron pills are available without a prescription.

Increased dietary intake of iron-rich foods:

Iron from animal foods is better absorbed than iron from plant sources or enriched foods.

Eating foods high in Vitamin C (e.g., citrus fruits and juices) along with a meal high in iron will help iron absorption from the intestine.

Some good sources of iron are: steak, hamburger, dried beans & peas, baked potato, broccoli, prune juice, spinach, shrimp, and ready-to-eat cereals (such as Cream of Wheat)

Constipation is the most common side effect of iron supplementation.  Docusate (brand name Colace) is a stool softener that can safely be taken in pregnancy to help with constipation.  It is available over the counter.  In addition, it is not unusual to have green or dark-colored stool while taking an iron supplement.

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