Risk Factors for Anemia in Pregnancy

All pregnant women are at risk for becoming anemic. That's because they need more iron and folic acid than usual. But the risk is higher in these situations:

• Pregnant with more than one child
• Two pregnancies close together
• Vomiting a lot because of morning sickness
• Teenager who is pregnant
• Don't eat enough foods that are rich in iron
• Heavy periods before you became pregnant

Symptoms of Anemia During Pregnancy

The most common symptoms of anemia during pregnancy are:

• Pale skin, lips, and nails
• Feeling tired or weak
• Dizziness
• Shortness of breath
• Rapid heartbeat
• Trouble concentrating

In the early stages of anemia, you may not have obvious symptoms. And many of the symptoms are ones that you might have while pregnant even if you're not anemic. So be sure to get routine blood tests to check for anemia at your prenatal appointments
Severe or untreated iron-deficiency anemia during pregnancy can increase your risk of:

• Preterm or low-birth-weight baby 
• Blood transfusion (if you lose a significant amount of blood during delivery)
• Postpartum depression

Untreated folate deficiency can increase your risk of having a:

• Preterm or low-birth-weight baby
• Baby with a serious birth defect of the spine or brain (neural tube defects)

Untreated vitamin B12 deficiency can also raise your risk of having a baby with neural tube defects.

Tests for Anemia

During your first prenatal appointment, you'll get a blood test so your doctor can check whether you have anemia. Blood tests typically include:

• Hemoglobin test. It measures the amount of hemoglobin -- an iron-rich protein in red blood cells that carries oxygen from the lungs to tissues in the body.
• Hematocrit test. It measures the percentage of red blood cells in a sample of blood.

If you have lower than normal levels of hemoglobin or hematocrit, you may have iron-deficiency anemia. Your doctor may check other blood tests to determine if you have iron deficiency or another cause for your anemia.
Even if you don't have anemia at the beginning of your pregnancy, your doctor will most likely recommend that you get another blood test to check for anemia in your second or third trimester.

Treatment for Anemia

If you are anemic during your pregnancy, you may need to start taking an iron supplement and/or folic acid supplement in addition to your prenatal vitamins. Your doctor may also suggest that you add more foods that are high in iron and folic acid to your diet.
In addition, you'll be asked to return for another blood test after a specific period of time so your doctor can check that your hemoglobin and hematocrit levels are improving.
To treat vitamin B12 deficiency, your doctor may recommend that you take a vitamin B12 supplement.
The doctor may also recommend that you include more animal foods in your diet, such as:

• meat
• eggs
• dairy products

Preventing Anemia

To prevent anemia during pregnancy, make sure you get enough iron. Eat well-balanced meals and add more foods that are high in iron to your diet.
Aim for at least three servings a day of iron-rich foods, such as:

• lean red meat, poultry, and fish
• leafy, dark green vegetables (such as spinach, broccoli, and kale)
• iron-enriched cereals and grains
• beans, lentils, and tofu
• nuts and seeds
• eggs

Foods that are high in vitamin C can help your body absorb more iron. These include:

• citrus fruits and juices
• strawberries
• kiwis
• tomatoes
• bell peppers

Try eating those foods at the same time that you eat iron-rich foods.  For example, you could drink a glass of orange juice and eat an iron-fortified cereal for breakfast.
Also, choose foods that are high in folic acid to help prevent folate deficiency. These include:

• leafy green vegetables
• citrus fruits and juices
• fortified breads and cereals
• dried beans

Follow your doctor's instructions for taking a prenatal vitamin that contains a sufficient amount of iron and folic acid.
Vegetarians and vegans should talk with their doctor about whether they should take a vitamin B12 supplement when they're pregnant and breastfeeding.