General Information

DEFINITION--An inadequate level of hemoglobin during pregnancy. Hemoglobin is a protein that carries oxygen to body tissues.

BODY PARTS INVOLVED--Blood cells.

SEX OR AGE MOST AFFECTED--Pregnant females.

SIGNS & SYMPTOMS

Breathlessness. Tiredness, weakness or fainting. Paleness. Infrequent:

• Palpitations or an abnormal awareness of the heartbeat.
• Inflamed, sore tongue.
• Nausea.
• Headache.
• Forgetfulness.
• Jaundice.
• Abdominal pain.

CAUSES

• Poor diet with inadequate iron.
• Folic-acid deficiency.
• Loss of blood from bleeding hemorrhoids or gastrointestinal bleeding.
• Excess cooking of food, which destroys available iron and other nutrients.
• Even if iron and folic-acid intake are sufficient, a pregnant woman may become anemic because pregnancy alters the digestive process. The fetus consumes some of the iron or folic acid normally available to the mother's body.

RISK INCREASES WITH

• Poor nutrition, especially multiple vitamin deficiencies.
• Smoking, which reduces absorption of important nutrients.
• Excess alcohol consumption, leading to poor nutrition.
• Medical history of any disorder that reduces absorption of nutrients.
• Use of anticonvulsant drugs.
• Previous use of oral contraceptives.

HOW TO PREVENT

• Eat foods rich in iron, such as liver, beef, whole-grain breads and cereals, eggs and dried fruit.
• Eat foods high in folic acid, such as wheat germ, beans, peanut butter, oatmeal, mushrooms, collards, broccoli, beef liver and asparagus.
• Eat foods high in vitamin C, such as citrus fruits and fresh, raw vegetables. Vitamin C makes iron absorption more efficient.
• Take prenatal vitamin and mineral supplements, if your doctor prescribes them.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies of hemoglobin, iron, hematocrit and folic acid.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Premature labor.
• Dangerous anemia from normal blood loss during labor, requiring blood transfusions.
• Increased susceptibility to infection after childbirth.

PROBABLE OUTCOME--Usually curable with iron and folic-acid supplements by mouth or by injection.

How To Treat

GENERAL MEASURES--

• If the tongue is red and sore, rinse with warm salt water 3 or 4 times a day. Use 1 teaspoon salt to 8 oz. warm water.
• Brush teeth with a soft toothbrush.

MEDICATION--Your doctor may prescribe iron, folic acid and other supplements. For better absorption, take iron supplements 1 hour before eating or between meals. Iron will turn bowel movements black and often cause constipation.

ACTIVITY--No restrictions, except rest often until anemia disappears.

DIET--Eat well and take prescribed supplements. Increase fiber and fluid intake to prevent constipation. See How to Prevent for diet suggestions.

Call Your Doctor If