Researchers in the UK and US analysed the results of over 90 studies and found taking daily iron supplements during pregnancy reduced the chances of having a small baby as well as anaemia by up to 12 per cent. They found even taking tiny amounts of iron can dramatically improve low birth weight – a leading cause of complication and death. 

The research that involved nearly two million women found that the positive effects were seen for iron doses up to 66 mg per day. Pregnant women commonly are not given iron supplements unless their iron levels are found to be low. Traditionally low iron levels were only associated with bleeding disorders. 

Iron deficiency is the most common and widespread nutritional disorder according to the World Health Organization (WHO). In developing countries, 50 per cent of pregnant woman and about 40 per cent of pre-school children are estimated to be anaemic.

Anaemia contributes to 20 per cent of all maternal deaths according to the WHO. Severe bleeding after birth can kill a healthy woman within two hours if she is unattended. Iron deficiency also contributes to poor brain and physical development, extreme fatigue and an increased risk of death. 

Poor access to healthcare services in many regions makes it difficult to fully gauge the true magnitude of this global threat. To compound the problem, infections such as tuberculosis, HIV, hookworm, schistosomiasis and malaria are also known to exacerbate the occurrence of anaemia. 

What is iron deficiency anaemia?

Anaemia is an expensive condition and contributes significantly to the overall disease burden of the nation. The good news is that the treatment and prevention of anaemia is both inexpensive and effective.

Iron is a required component in hundreds of enzymes and functions in the human body. One of the most important functions is that iron aids in the transport of oxygen throughout the body. Oxygen is required for proper function and healing. Iron is also involved in the energy metabolism of the body. Energy metabolism simply means how one’s body is able to produce, use and store energy for the current and future bodily needs. 

Initially, iron deficiency anaemia can be mild and can go undiagnosed until the symptoms intensify. Symptoms include shortness of breath, a fast heartbeat, dizziness or light-headedness, weakness and headache. Other symptoms include cold hands and feet, irritability and brittle nails.

What causes iron deficiency anaemia?

Low levels of iron in the body can be from a variety of causes. A common culprit is heavy menstrual bleeding associated with a woman’s monthly cycle. Internal bleeding can also cause iron deficiency anaemia. This is usually caused by problems such as ulcers, haemorrhoids or cancer. Bleeding ulcers can also be associated with excessive aspirin use. 

Digestive tract disorders such as Crohn’s and celiac disease can prevent the body’s ability to absorb iron from one’s diet as well. Anaemia of inflammation and chronic disease (AI/ACD) closely resembles iron deficiency anaemia but is associated with chronic, or long-term, illnesses or infections.

Infectious diseases that cause AI/ACD include HIV, tuberculosis, endocarditis-an infection of the heart—and osteomyelitis, a bone infection. Other inflammatory diseases that can lead to AI/ACD include rheumatoid arthritis, lupus, diabetes, heart failure, degenerative joint disease, and inflammatory bowel disease, says the National Hematologic Diseases Information Service.

How do you know your iron level?

One’s iron levels are checked at specific times during pregnancy and other times that a medical history and physical exam warrants the test. Appropriate action is taken if required, such as dietary advice and/or an iron supplement may be recommended.

If you think you’re anaemic, do not try to treat yourself. Do not attempt to take iron pills on your own without seeing your doctor first. Iron supplementation is not right for everyone as it is possible to have too much iron in your blood. A low iron level may be caused by a serious problem that needs immediate treatment. 

Women who are intolerant to iron supplements can suffer from indigestion, bloating and other stomach problems. Finding the dose that works for you is important.

Risk factors for anaemia in pregnancy 

All pregnant women are at risk for becoming anaemic and should be checked. Pregnancy and eventual breastfeeding requires more iron and folic acid than usual. The anaemic risk is higher in a pregnancy with more than one child, two pregnancies close together and a teenager who is pregnant. Morning sickness and vomiting can cause an iron deficiency as well. This may or not be associated with eating enough foods that contain iron.

Foods rich in iron

An individual with iron deficiency anaemia should increase their iron intake. This can be done through eating iron-rich foods, eating foods that are fortified with iron and iron supplementation. Both animal and plant sources can be high in iron. The amount of iron that one’s body can absorb will depend on the type of iron and the type of other nutrients consumed in the same meal.  

Animal sources of iron contain a form of iron called heme iron. Heme iron is the form of iron that is most readily absorbed. Non-heme iron is found in plant sources. Good sources of heme iron include beef, chicken, eggs, fish and certain organ meats. Heme iron is absorbed two to three times more efficiently in comparison to non-heme iron. 

Non-heme iron that is found in vegetable and plant sources are affected by other nutrients in that meal. Consuming heme iron has even been found to enhance the absorption of non-heme iron. One of the most important nutrients to consume with plant-based iron is foods that contain vitamin C. Vitamin C activates the absorption of non-heme iron. Vitamin C can be found in broccoli, leafy green vegetables, citrus fruits, peppers and tomatoes.

Good sources of non-heme iron include spinach, green peas, sweet potato, walnuts, beans and prunes. Several studies have shown substances such as coffee, tea and some legumes to decrease the absorbable amount of non-heme iron. 

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