IRON DEFICIENCY ANEMIA IN PREGNANT WOMEN





IRON-DEFICIENCY ANEMIA
Iron deficiency anemia is the most common type of anemia, and it occurs when your body doesn't have enough of the mineral iron. Your body needs iron to make hemoglobin. When there isn't enough iron in your blood stream, the rest of your body can't get the amount of oxygen it needs
Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues.
As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron, your body can't produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin). As a result, iron deficiency anemia may leave you tired and short of breath.
WHO GETS IRON-DEFICIENCY ANEMIA?
Iron-deficiency anemia affects more women than men. The risk of iron-deficiency anemia is highest for women who:
  • Are pregnant. Iron-deficiency anemia affects one in six pregnant women.You need more iron during pregnancy to support your unborn baby’s development.

  • Have heavy menstrual periods. Up to 5% of women of childbearing age develop iron-deficiency anemia because of heavy bleeding during their periods.

Infants, small children, and teens are also at high risk for iron-deficiency anemia. 
SYMPTOMS OF IRON-DEFICIENCY ANEMIA
Iron-deficiency anemia often develops slowly. In the beginning, you may not have any symptoms, or they may be mild. As it gets worse, you may notice one or more of these symptoms:

  • Fatigue (very common)
  • Weakness (very common)
  • Dizziness
  • Headaches
  • Low body temperature
  • Pale or yellow "sallow" skin
  • Rapid or irregular heartbeat
  • Shortness of breath or chest pain, especially with physical activity
  • Brittle nails
  • Pica (unusual cravings for ice, very cold drinks, or non-food items like dirt or paper)
If you think you may have iron-deficiency anemia, talk to your near doctor.

CAUSES IRON-DEFICIENCY ANEMIA
Women can have low iron levels for several reasons:
  • Iron lost through bleeding. Bleeding can cause you to lose more blood cells and iron than your body can replace. Women may have low iron levels from bleeding caused by:
    • Digestive system problems, such as ulcers, colon polyps, or colon cancer
    • Regular, long-term use of aspirin and other over-the-counter pain relievers
    • Donating blood too often or without enough time in between donations for your body to recover
    • Heavier or longer than normal menstrual periods
    • Uterine fibroids, which are noncancerous growths in the uterus that can cause heavy bleeding
  • Increased need for iron during pregnancy. During pregnancy, your body needs more iron than normal to support your developing baby.
  • Not eating enough food that contains iron. Your body absorbs the iron in animal-based foods, such as meat, chicken, and fish, two to three times better than the iron in plant-based foods. Vegetarians or vegans, who eat little or no animal-based foods, need to choose other good sources of iron to make sure they get enough.Your body also absorbs iron from plant-based foods better when you eat them with foods that have vitamin C, such as oranges and tomatoes. But most people in the United States get enough iron from food.
  • Problems absorbing iron. Certain health conditions, such as Crohn's disease or celiac disease, or gastric bypass surgery for weight loss can make it harder for your body to absorb iron from food.
·         Your diet is low in iron. How much iron you need depends on your age and gender. Men need at least 8 milligrams (mg) daily. Women ages 50 and younger need more -- 18 mg.

·         Your body can't absorb iron. Iron from the foods you eat is absorbed in your small intestine. Conditions like celiac disease, ulcerative colitis, or Crohn's disease can make it harder for your intestines to absorb iron. Surgery such as gastric bypass that removes part of your intestines, and medicines used to lower stomach acid can also affect your body's ability to absorb iron.

WHEN TO SEE A DOCTOR

If you or your child develops signs and symptoms that suggest iron deficiency anemia, see your doctor. Iron deficiency anemia isn't something to self-diagnose or treat. So see your doctor for a diagnosis rather than taking iron supplements on your own. Overloading the body with iron can be dangerous because excess iron accumulation can damage your liver and cause other complications.
HOW IS IRON-DEFICIENCY ANEMIA DIAGNOSED?
Talk to your best doctor if you think you might have iron-deficiency anemia. Your doctor may:
  • Ask you questions about your health history, including how regular or heavy your menstrual periods are. Your doctor may also ask you about any digestive system problems you may have, such as blood in your stool.
  • Do a physical exam
  • Talk to you about the foods you eat, the medicines you take, and your family health history
  • Do blood tests. Your doctor will do a complete blood count (CBC). The CBC measures many parts of your blood. If the CBC test shows that you have anemia, your doctor will likely do another blood test to measure the iron levels in your blood and confirm that you have iron-deficiency anemia.  
If you have iron-deficiency anemia, your family doctor may want to do other tests to find out what is causing it.

HOW IS IRON-DEFICIENCY ANEMIA TREATED?
Treatment for iron-deficiency anemia depends on the cause:
  • Blood loss from a digestive system problem. If you have an ulcer, your doctor may give you antibiotics or other medicine to treat the ulcer. If your bleeding is caused by a polyp or cancerous tumor, you may need surgery to remove it. 
  • Blood loss from heavy menstrual periods. Your doctor may give you hormonal birth control to help relieve heavy periods. If your heavy bleeding does not get better, your doctor may recommend surgery. Types of surgery to control heavy bleeding include endometrial ablation, which removes or destroys your uterine lining, and hysterectomy, which removes all or parts of your uterus.
  • Increased need for iron. If you have problems absorbing iron or have lower iron levels but do not have severe anemia, your doctor may recommend:
    • Iron pills to build up your iron levels as quickly as possible. Do not take any iron pills without first talking to your doctor or nurse.
    • Eating more foods that contain iron. Good sources of iron include meat, fish, eggs, beans, peas, and fortified foods (look for cereals fortified with 100% of the daily value for iron).
    • Eating more foods with vitamin C. Vitamin C helps your body absorb iron. Good sources of vitamin C include oranges, broccoli, and tomatoes.
If you have severe bleeding or symptoms of chest pain or shortness of breath, your doctor may recommend iron or red blood cell transfusions. Transfusions are for severe iron deficiencies only and are much less common.

HOW CAN I PREVENT IRON-DEFICIENCY ANEMIA?
You can help prevent iron-deficiency anemia with the following steps:
  • Treat the cause of blood loss. Talk to your doctor if you have heavy menstrual periods or if you have digestive system problems, such as frequent diarrhea or blood in your stool.
  • Eat foods with iron. Good sources of iron include lean meat and chicken, dark, leafy vegetables, and beans.
  • Eat and drink foods that help your body absorb iron, like orange juice, strawberries, broccoli, or other fruits and vegetables with vitamin C.
  • Make healthy food choices. Most people who make healthy, balanced food choices get the iron and vitamins their bodies need from the foods they eat.
  • Avoid drinking coffee or tea with meals. These drinks make it harder for your body to absorb iron.
  • Talk to your doctor if you take calcium pills. Calcium can make it harder for your body to absorb iron. If you have a hard time getting enough iron, talk to your doctor about the best way to also get enough calcium.
HOW MUCH IRON DO I NEED EVERY DAY?
The chart below lists how much iron you need every day. The recommended amounts are listed in milligrams (mg). See a list of good sources of iron.
Age
Women
Pregnant women
Breastfeeding women
Vegetarian women*
14–18 years
15 mg
27 mg
10 mg
27 mg
19–50 years
18 mg
27 mg
9 mg
32 mg
51+ years
8 mg
n/a
n/a
14 mg
Source: Adapted from Institute of Medicine, Food and Nutrition Board
*Vegetarians need more iron from food than people who eat meat do. This is because the body can absorb iron from meat better than from plant-based foods.

DO I NEED MORE IRON DURING PREGNANCY?
Yes. During pregnancy, your body needs more iron to support your growing baby. In fact, pregnant women need almost twice as much iron as women who are not pregnant do. Not getting enough iron during pregnancy raises your risk for premature birth or a low-birth-weight baby (less than 5 ½ pounds). Premature birth is the most common cause of infant death. Both premature birth and low birth weight raise your baby's risk for health and developmental problems at birth and during childhood.
If you're pregnant, talk to your doctor about these steps:
  • Getting 27 milligrams of iron every day. Take a prenatal vitamin with iron every day, or talk to your doctor about taking an iron supplement (pill).
  • Testing for iron-deficiency anemia
  • Testing for iron-deficiency anemia four to six weeks after childbirth
DO I NEED MORE IRON IF I AM BREASTFEEDING?
No, you do not need more iron during breastfeeding. In fact, you need less iron than before you were pregnant. The amount of iron women need during breastfeeding is 10 milligrams per day for young mothers 14 to 18 and 9 milligrams per day for breastfeeding women older than 18.
You need less iron while breastfeeding because you likely will not lose a lot through your menstrual cycle. Many breastfeeding women do not have a period or may have only a light period. Also, if you got enough iron during pregnancy (27 milligrams a day), your breastmilk will supply enough iron for your baby.

DOES BIRTH CONTROL AFFECT MY RISK FOR IRON-DEFICIENCY ANEMIA?
It could. Hormonal birth control, such as the pill, the patch, the shot, or the hormonal intrauterine device (IUD), is often used to treat women with heavy menstrual periods. Lighter menstrual periods may reduce your risk for iron-deficiency anemia. Also, the non-hormonal, copper IUD (Paragard) may make your menstrual flow heavier. This raises your risk for iron-deficiency anemia.
Talk to your doctor about your risk for anemia and whether hormonal birth control may help.


   Dr. Suchi Gupta's Gynae Clinic 

(Gynaecologist in Gaur City, Greater Noida West, Noida Extension)

Shop No 130, FF, Gaur City Plaza Market, West, Gaur City 1 Rd, Greater Noida, Uttar Pradesh 201301

     http://www.drsuchiguptagynaeclinic.com/



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