Anaemia (Greek: an=without and haem=blood) is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet the needs of the body. Anaemia may be due to i) blood loss, ii) decreased red cell production or iii) increased red cell destruction.
The diagnosis of anaemia is based on the haemoglobin concentration in the blood. Haemoglobin is the protein in the red cells that carries oxygen to the tissues. Iron is required for the synthesis of haemoglobin. In addition, vitamin B12 and folic acid are also needed for the production of red cells. A lack of any of these can lead to anaemia, the most common being iron-deficiency anaemia. Requirements for iron in pregnancy are three times higher than in non-pregnant women and the requirement increases as pregnancy advances. Worldwide, one third of pregnant women are anaemic.
Certain conditions put the mother at greater risk of anaemia:
- Pre-pregnancy anaemia
- Inadequate spacing between pregnancies
- Pregnancy with twins or triplets
- Inadequate iron supplementation
Symptoms of anaemia
The most common symptoms of anaemia are:
- Weakness and easy fatigability
- Awareness of heartbeat
- Shortness of breath
- Pale lips and skin
Some of them overlap with general pregnancy symptoms. However, regardless of symptoms, all pregnant women should be screened for anaemia. If anaemia becomes severe, it might be harmful to the mother as well as the baby. Poor work capacity, susceptibility to infection, heart failure, premature and low birth weight babies, excessive bleeding after delivery are some of the complications associated with anaemia in pregnancy.
Prevention and treatment of anaemia
- Ensuring normal haemoglobin level before conception
- Iron-rich foods: dark green leafy vegetables, red meat, eggs, peanuts, dried beans and peas, iron-fortified foods, dried fruits such as apricots and raisins
- Pairing iron-rich food or iron tablets with a food or drink high in vitamin C (lemon juice, citrus fruits or strawberries) can enhance the absorption of iron
- Calcium, on the other hand, decreases iron absorption and should not be taken in combination with iron-rich food or tablets
- Folic acid and vitamin B12 should also be supplemented if found deficient
- Women who are intolerant to oral iron tablets may be advised iron injections
- Women suffering from severe anaemia may need blood transfusion