Pregnancy is a very special time, a time of so many physical and emotional changes. Feeling your baby kick for the first time and watching it grow inside of you is no less than an amazing experience. And while some really enjoy being pregnant, other people, like me, can experience a slew of not-so-great symptoms and complications.
The most common pregnancy complication around the world is anemia, or iron deficiency. In the United States, 24.1% of pregnant women are reported to have anemia [1]. When you have anemia, your hemoglobin levels are low (<11g/dL), meaning you do not have sufficient red blood cells to carry oxygen to the tissues in your body. While there are several possible causes of anemia during pregnancy, the most common cause is iron deficiency.
Common symptoms you may experience from iron deficiency include:
● Difficulty sleeping [2,3]
Why is anemia so common during pregnancy?
Pregnancy is a critical time because of the increased needs of iron to support the placenta, growing baby, red blood cell production and 50% increase in plasma volume [4,5]. This is why the recommended daily intake of iron increases from 18mg pre-pregnancy to 27mg during pregnancy.
The problem is, many women do not have adequate stores of iron even before beginning their pregnancy and therefore become deficient as the needs for iron increases with each trimester [6]. This lack of iron could stem from an iron-deficient diet, poor absorption of iron in the gut, blood loss from pre-pregnancy menstruation or other medical conditions [3]. Those who have a history of anemia, have short intervals between pregnancies, and those who carry twins or triplets are at higher risk of experiencing iron deficiency too.
What is the big deal?
A number of studies have linked iron deficiency and anemia to a variety of complications for both the baby and mother. A 1992 study by Scholl et al. found that iron-deficiency anemia during the first two trimesters of pregnancy led to a twofold increased risk for preterm delivery and a threefold increased risk for delivering a low-birthweight baby [7,8]. Other studies have reported similar findings, as well as neurodevelopmental delays, and higher risks of developing pre-eclampsia, needing blood transfusion at birth, and thyroid autoimmunity or dysfunction in mothers [9-14].
And the complications don’t end when the pregnancy is over. The probability of hemorrhage during birth skyrockets when the mother is anemic during pregnancy. One study looking at the relationship between anemia during pregnancy and uterine atony, the main cause of postpartum hemorrhage, found that 80% of the women who underwent emergency hysterectomies following severe hemorrhaging were anemic during pregnancy (with a hemoglobin level <7 versus 12.5% of the non-hysterectomized group) [15].
All of these risks point to the importance of having adequate levels of iron before, during, and after your pregnancy.
The good news is that anemia is totally preventable
You can increase your intake of iron by incorporating iron-rich foods into your diet. Animal products that contain the most absorbable heme iron, such as organ meats (liver, heart), oysters, beef, clams, lamb, poultry, and sardines are the best food sources of iron. Other sources include legumes and dark leafy greens.
You can increase your body’s absorption of iron by consuming these iron-rich foods with vitamin C (fruits, tomatoes, spinach, cabbage, cauliflower, potatoes, and other green leafy vegetables) [16]. You can also increase the iron in your food by cooking in cast iron pots. Studies have reported increases anywhere from 2 to 24 times the amount of iron in the food compared to cooking in other pans [17].
Cooking and eating with organ meats may not be appealing to many pregnant women, so an alternative is to take a desiccated liver supplement like Mother Nutrient’s Grass-fed Beef Liver Capsules. You can get all the benefits of obtaining high levels of iron (and many other important nutrients) without the taste of liver.
Iron supplementation
When diet alone is not sufficient to increase your iron levels, the next step is to take an iron supplement. Iron supplementation is known to increase maternal iron levels, increase birth weight, and reduce risks for low birthweight in deficient mothers, especially when started in early pregnancy [5,10].
Iron supplements have a bad rap for their taste and causing constipation. Recent studies looking at different forms of iron supplementation found that compared to the commonly prescribed ferrous sulfate, iron bisglycinate reported fewer side effects and is better absorbed [18,19].
Mother Nutrient offers a chewable iron chelate (ferrous glycinate) supplement that is gentle on the stomach, has great taste and is non-constipating. It delivers the highest dose of 30 mg of iron and is safe for pregnant and lactating mothers as well.
It’s clear that maintaining iron levels throughout pregnancy is important. It is always beneficial to have your doctor monitor your iron levels before and during your pregnancy (done through blood tests checking hemoglobin, hematocrit, and ferritin levels) so that you can nourish your baby and yourself with the necessary amounts of iron.
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Are you experiencing iron deficiency during your pregnancy? Share your experience with me in the comments below!
Content found on this website is not considered medical advice. Please consult with a physician before making any medical or lifestyle changes.
1. “Worldwide Prevalence on Anaemia 1993-2005.” World Health Organization, World Health Organization, 5 Nov. 2010, https://www.who.int/vmnis/database/anaemia/anaemia_status_summary/en/.
2. Abu-Ouf, Noran, and Mohammed Jan. “The Impact of Maternal Iron Deficiency and Iron Deficiency Anemia on Child’s Health.” Saudi Medical Journal. 2015;36(2):146–149., doi:10.15537/smj.2015.2.10289.
3. Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–174.
4. Erdman JW, MacDonald I, Zeisel SH. Present knowledge in nutrition. 10th ed. Washington, DC: International Life Sciences Institute; 2012
5. Mcmahon, Lawrence P. “Iron Deficiency in Pregnancy.” Obstetric Medicine. 2010; 3(1):17–24., doi:10.1258/om.2010.100004.
6. Turner RE, Langkamp-Henken B, Littell RC, Lukowski MJ, Suarez MF. Comparing nutrient intake from food to the estimated average requirements shows middle- to upper-income pregnant women lack iron and possibly magnesium. J Am Diet Assoc 2003;103:461–6
7. Scholl TO, Hediger ML, Fischer RL, Shearer JW. Anemia vs iron deficiency: increased risk of preterm delivery in a prospective study. Am J Clin Nutr 1992;55:985-8
8. Scholl T. Iron status during pregnancy: Setting the stage for mother and infant. Am J Clin Nutr. 2005;81:1218S-1222S.
9. Cogswell, Mary E, et al. “Iron Supplementation during Pregnancy, Anemia, and Birth Weight: a Randomized Controlled Trial.” The American Journal of Clinical Nutrition. 2003;78 (4):773–781., doi:10.1093/ajcn/78.4.773.
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11. Veltri, Flora, et al. “Prevalence of Thyroid Autoimmunity and Dysfunction in Women with Iron Deficiency during Early Pregnancy: Is It Altered?” European Journal of Endocrinology. 2016; 175(3):191–199., doi:10.1530/eje-16-0288.
12. Breymann, Christian. “Iron Deficiency Anemia in Pregnancy.” Seminars in Hematology. 2015; 52(4):339–347., doi:10.1053/j.seminhematol.2015.07.003.
13. Ali, Abdelaziem A, et al. “Severe Anaemia Is Associated with a Higher Risk for Preeclampsia and Poor Perinatal Outcomes in Kassala Hospital, Eastern Sudan.” BMC Research Notes. 2011;4(1), doi:10.1186/1756-0500-4-311.
14. Scanlon KS, Yip R, Schieve LA, Cogswell ME. High and low hemoglobin levels during pregnancy: differential risks for preterm birth and small for gestational age. Obstet Gynecol 2000;96:741–8.
15. Frass, K. Postpartum hemorrhage is related to the hemoglobin levels at labor: Observational study. Alexandria Journal of Medicine. 2015; 51(4):333-337
16. Gautam CS, Saha L, Sekhri K, Saha PK. Iron deficiency in pregnancy and the rationality of iron supplements prescribed during pregnancy. Medscape J Med. 2008;10(12):283.
17. Kroger-Ohlsen M, Trugvason T, Skibsted L, Michaelsen K. Release of Iron into Foods Cooked in an Iron Pot: Effect of pH, Salt, and Organic Acids. Journal of Food Science. 2002;67:3301–3.
18. Melamed, Nir, et al. “Iron Supplementation in Pregnancy—Does the Preparation Matter?” Archives of Gynecology and Obstetrics, 2007;276(6):601–604., doi:10.1007/s00404-007-0388-3.
19. Milman N, Jonsson L, Dyre P, Pedersen PL, Larsen LG. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. J Perinat Med. 2014 Mar;42(2):197-206.
