Anaemia during pregnancy is common but is also linked to some serious complications, so it’s important to know the signs and symptoms of anaemia in pregnancy so you can get tested for the condition, the right treatment, and help with managing it as soon as possible.
Anaemia during pregnancy should never be left untreated as it can increase the risk of complications during pregnancy and birth. GPs Dr Semiya Aziz and Dr Vikram Murthy shared their advice with us on the subject of anaemia and pregnancy, including common signs and symptoms to look out for and why it’s important to get checked as soon as possible if you think you might have the condition.
You can get anaemia at any time if you are pregnant or not. If you have any symptoms of anaemia, please speak to your doctor.
The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP and take note of official NHS advice. You should immediately seek medical attention if you think you might have anaemia and are pregnant. If you are unsure, concerned about your symptoms or feel unwell, then it is crucial to seek personalised advice from a doctor as soon as possible.
What is anaemia and can it be caused by pregnancy?
"Anaemia is a broad condition where the number of red blood cells or the haemoglobin concentration within them is lower than normal," explains Dr Vikram Murthy. "Haemoglobin is a protein found in red blood cells. It picks up oxygen from the lungs and carries it around the body." Dr Semiya Aziz explains that the result of this is, "a reduction of oxygen being transported to tissues within the body."
Although there are multiple different causes of anaemia - ranging from iron deficiency, vitamin B12 deficiency and folate deficiency, to immune system problems and long term chronic diseases - Dr Murthy explains that the most common in pregnancy is iron deficiency anaemia. "In pregnancy, iron deficiency is the main cause and this is due to the volume of blood in the body increasing. As a result, your requirement for iron increases as this is used to make more blood to supply oxygen to your baby. A lack of iron can cause iron deficiency anaemia."
What are common signs and symptoms of anaemia in pregnancy
"Signs and symptoms of anaemia commonly seen in pregnancy include fatigue, weakness, pale skin, shortness of breath, dizziness, headaches, or a fast heart rate," says Dr Aziz.
In addition, Dr Murthy told us that anaemia in pregnancy can also cause a lack of energy, irritability and a noticeable heartbeat (heart palpitations).
You should see your GP as soon as possible if you think you might have iron deficiency anaemia.
How is anaemia in pregnancy treated?
As with any pregnancy symptoms, you will need to see your doctor if you think you have anaemia. They will ask you about your lifestyle and medical history, as well as running a full blood count (FBC) test.
"A simple blood test can check the iron, B12 and folate levels," Dr Murthy explains. Once the cause of your anaemia has been identified, your GP will recommend the best treatment for you. This might be in the form of supplements like iron tablets.
"Like any iron deficiency anaemia, treatment typically relies on the use of iron supplements, which can help to replenish depleted iron stores and improve red blood cell production," says Dr Aziz.
Dr Murthy explains, "If there is an iron deficiency, a simple iron tablet to take one, two or three times a day depending on your iron levels is a safe and easy solution. Similar medication is also available for vitamin b12 and folate deficiency. A folic acid supplement should be taken as soon as possible from finding out you are pregnant as this can reduce neural tube defects."
If diagnosed with anaemia whilst pregnant your doctor or healthcare provider will want to keep monitoring you throughout your pregnancy.
In addition to supplements or tablets, Dr Aziz also explained to us that good nutrition and a healthy diet are also really important when it comes to preventing or managing anaemia in pregnancy. "It is also important to encourage good dietary habits and advise on taking prenatal vitamins that contain iron with vitamin c which helps to aid absorption," Dr Aziz said.
Foods to eat and avoid if you are anaemic while pregnant
"Good nutrition is the best way to prevent anaemia in pregnancy,” Dr Murthy states. “You are more likely to develop anaemia if you are vegetarian or vegan. Good sources of iron include pulses, dark green vegetables, wholemeal bread, dried fruit such as apricots and fortified breakfast cereals. Other good sources of iron include lean red meat, poultry, eggs and fish."
Dark green leafy vegetables include products like watercress and curly kale, whilst dried fruit like prunes and raisins are also good in addition to Dr Murthy’s recommendation of apricots.
Dr Aziz expands, "A healthy balanced diet focusing on eating the rainbow whilst being pregnant should always be encouraged. Pregnant women should focus on consuming iron-rich foods such as lean meats, poultry, fish, beans, lentils, tofu, fortified cereals, spinach, and other leafy green vegetables. Adding in foods rich in vitamin-C may be beneficial and enhance iron absorption. This can be done by incorporating fruits and vegetables such as citrus fruits, strawberries, tomatoes and bell peppers into meals.
As well as ensuring you are eating a healthy, balanced diet during pregnancy, there are also some foods and drinks to avoid - especially if you are anaemic. "It is also important to avoid foods and beverages that can inhibit iron absorption, such as coffee, tea, and calcium-rich foods, within a few hours of consuming iron-rich foods."
The NHS also recommends that you should avoid, "foods with high levels of phytic acid, such as wholegrain cereals, which can stop your body absorbing iron from other foods and tablets."
How does anaemia affect pregnancy and what are the possible complications caused by anaemia in pregnancy?
Anaemia can cause a greater risk of complications before and after birth if you're pregnant, so it is vital that you seek medical attention if you think you might have anaemia and are pregnant.
"Anaemia during pregnancy should never be left untreated as it can increase the risk of complications, such as preterm birth, low birth weight and maternal fatigue," Dr Aziz warns. "In some cases severe anaemia may also increase the risk of maternal and foetal complications during the phase of labour and delivery. Anaemia in pregnancy can also lead to an increased risk of requiring blood transfusions during childbirth or if postpartum haemorrhage should occur."
Dr Murthy echoes the warnings shared by Dr Aziz and impresses the importance of seeing a doctor as soon as possible to get anaemia diagnosed and treated if you are pregnant: "Anaemia in pregnancy can lead to an increased risk of infections and more prone to illnesses as a lack of iron affects the immune system. It can cause greater risk of complications before and after birth and may also increase your risk of developing complications that affect your heart or lungs such as a fast heartbeat or heart failure. Anaemia is linked to a higher risk of increased maternal morbidity and foetal death so it is very important to screen, manage and treat this condition."
Can you get anaemia after pregnancy?
Yes, you can get anaemia at any time if you are pregnant or not. Dr Murthy advises, "If you have any symptoms of anaemia, please speak to your doctor."
Dr Aziz explains anaemia can be caused by certain birth experiences, "If there is significant blood loss during childbirth or if the woman's iron stores were depleted during pregnancy, it is inevitable that a woman will develop anaemia after pregnancy."
What to do if you think you might have anaemia either during or after pregnancy
"If there is any suspicion of anaemia during or after pregnancy, noted from the signs and symptoms of anaemia in pregnancy previously described, it would be essential to speak with your healthcare professional," Dr Aziz advises. "A simple blood test would be carried out to determine haemoglobin levels and hence anaemia. If anaemia is diagnosed, your healthcare professional would be able to recommend appropriate treatment."
Dr Murthy adds, "See your doctor, midwife or health visitor to discuss your concerns. A simple blood test can check to see if you are anaemic and treatment can be started very quickly. Screening is offered on the NHS to all pregnant women. Everyone will have a booking appointment between 8-12 weeks and usually have another review at 16 weeks when a blood test is reviewed and iron supplements may be offered based on the results of a blood test."
You can also access information for patients on preventing and treating anaemia during pregnancy from Imperial College Healthcare here and further information on anaemia and pregnancy from charity Tommy's here.
