Low Hemoglobin During Pregnancy

Every time I go to my check-up, my hemoglobin always low but its still under control. (My hemoglobin 9.0 - 10.5). Doctor said the normal of hemoglobin during pregnancy must over 11.5, I'm so worry but I need to eat more iron like spinach, suppliment like USANA. ;)


Anemia during Pregnancy

Anemia is a serious problem for women of child bearing age, because it can have devastating effects on their babies. Anemia usually is caused by deficiencies of iron and, rarely, of folic acid (folate).

Anemia can also be caused by a deficiency in red blood cell production.

Iron Deficiency Anemia develops slowly after normal stores of iron have been depleted. Women, in general, have smaller stores of iron than men and experience blood loss through menstruation. Therefore, anemia is more common in women than in men. During pregnancy, iron stores need to support the needs of mother and her growing fetus, who needs iron for the development of red blood cells, blood vessels, and muscle.

Approximately 95% of anemia cases during pregnancy are caused by iron deficiency. Inadequate dietary intake, normal menstrual blood loss, or recent pregnancy are the most common reasons for low iron reserves in pregnant women. During late pregnancy, especially during the last trimester, the rapidly-growing placenta and fetus increase maternal iron requirements. The mother’s body is designed to meet this higher demand for iron with a natural boost in red blood cell production. However, an even more pronounced increase in plasma volume leads to hemodilution, or hydremia of pregnancy. Hemodilution causes a drop in hematocrit (Hct) values from the normal range between 38% and 45% in non-pregnant women to between 30% and 34% in late pregnancy3. This drop in red blood cell count makes it nearly impossible for women to build up their iron reserves during that time, especially with conventional prenatal vitamins that contain low amounts of poorly-absorbed iron.

Effects of Anemia during Pregnancy on Mother and Child

If you are anemic, you may have no symptoms at all. You may feel weak and fatigued, especially when your baby’s weight becomes more significant towards the end of your pregnancy. Iron deficiency anemia sometimes leads to light-headedness and to mild dyspnea with activities such as climbing stairs. More severe anemia can cause tachycardia and hypotension and requires the attention of a qualified medical professional.

Maternal iron deficiency can have significant consequences for the development of your child. A retrospective analysis conducted by the Centers for Disease Control and Prevention found an increased risk of preterm birth in mothers with low hemoglobin levels during the first two trimesters of pregnancy.In non-African American women, moderately low maternal hemoglobin, defined as 9.0<10.0 g/dL during the first trimester and as 8.5<9.5 g/dL during the second trimester, also was associated with a higher risk of still birth. In addition, women with hemoglobin <10 g/dL during the first twelve weeks of pregnancy had a three-fold greater risk than their non-anemic counterparts of giving birth to an infant with low birth weight.21

Babies born to mothers with iron deficiency anemia usually present with low total iron stores and require dietary iron supplements.3 Iron supplementation of newborns is undesirable because iron can cause serious intestinal discomfort in their immature digestive systems. Iron deficiency during gestation and lactation also is associated with changes in nervous system development and functioning.23 For many children, iron deficiency remains a problem for years. According to the CDC, 7% of one-to-two-year-olds in the United States are iron deficient and 2% present with iron deficiency anemia.17 Children with iron deficiency anemia perform more poorly in cognitive and motor skills tests and show delayed social and emotional development.23

Iron Supplementation

To avoid iron deficiency during pregnancy, a woman should have an iron reserve of approximately 300 mg prior to conception.18 However, in the National Health and Nutrition Examination Survey (NHANES III), 52% of women of child-bearing age did not meet that requirement. Therefore, even though there is some concern about possible overdose from daily iron supplementation, iron is an important component included in almost all prenatal dietary supplements.

Dietary iron supplements need to be taken over the course of several months to be effective. In pregnant women, iron supplementation through the use of a daily multivitamin during the first two trimesters resulted in significantly (p<0.05) higher levels of serum iron (ferritin) levels at Week 28 of pregnancy when compared with non-use. A review of literature indicated that prenatal iron supplementation resulted in higher maternal hemoglobin levels during pregnancy but also after birth. Iron supplementation during late pregnancy usually does not affect maternal prenatal health or delivery, but it does improve iron status throughout the first year of life.