Congratulations, you are pregnant! Like any new beginning, the period of pregnancy and childbirth brings with it great excitement along with concerns and doubts. In February, the Ministry of Health marks Healthy Pregnancy Planning Week, and on the occasion of this date it is important to explain why it is important to consume iron during pregnancy and of course also after birth.
Many women during the fertile period suffer from a lack of iron, but during pregnancy the situation is extreme and a considerable percentage of pregnant women may suffer from a lack of iron. Already in the first trimester of pregnancy, the fetus begins to develop and there is an increase in blood volume, therefore there is an increased demand of the body for iron. This is the reason why the Ministry of Health published guidelines for taking iron supplements during pregnancy to prevent anemia.
Comfort Altman iron with added vitamin C (photo: IACHT)
Why is it important to take iron during pregnancy?
Iron is an essential mineral, responsible for transporting oxygen from the lungs to the body’s organs and tissues through hemoglobin. The importance of taking iron during pregnancy is twofold: it is important for the health of the mother as well as for the health of the baby. During pregnancy, the woman’s blood volume increases as the body’s defense mechanism prepares for the expected bleeding at birth. In addition, it is important to understand that a fetus growing in the womb is a huge consumer of nutrients (substances of nutritional importance), which the mother’s body provides. The fetus grows at a rapid rate and builds a large amount of systems in its body, a kind of factory that draws all its building blocks from the existing reserves – and iron is a significant building block.
What causes iron deficiency in pregnancy?
Women normally have a lower hemoglobin level than men. In addition, women of reproductive age bleed every month – and can lose iron and reach even lower hemoglobin levels. If the woman’s routine diet contains less iron, its level can further decrease. Therefore, many women start early in pregnancy with a hemoglobin that is lower than desired and with iron deficiency anemia that only gets worse during pregnancy. In fact, anemia can be caused by several factors. It can be related to a lack of iron, folic acid or vitamin B 12 and there are rarer causes. The most common condition is iron deficiency anemia.
Is there no iron deficiency in pregnancy?
The first symptoms are fatigue, sometimes also shortness of breath, paleness, dizziness and weakness due to the low hemoglobin and depleted iron stores. One of the goals is to increase iron intake already during pregnancy to prepare the woman for childbirth, since childbirth itself is traumatic for the body and during it the woman loses large amounts of blood. Even after giving birth, the mother needs iron, especially if she is breastfeeding, to nourish the baby.
The Fluorital TO GO case contains 10 vials, 10 ml each. Recommended price for the consumer NIS 79.90 (Photo: Yechat)
How much iron deficiency can harm the fetus?
There are currently studies according to which anemia in pregnancy increases the risk of complications around birth, such as premature birth and low birth weight of the fetus, and may even harm the cognitive development and growth of the baby. In addition, the more the pregnancy has multiple fetuses, the more iron consumption should be increased, since the fetuses require more iron and the birth is more complex.
What is the recommendation for pregnant women?
Iron monitoring in pregnancy starts already in the first trimester, but from the second trimester the iron consumption is more significant. Despite this, the recommendation is to take iron from the beginning of pregnancy, since it takes a long time to build iron stores in the body. If you preserve the iron stores, among other things by taking iron supplements, you do not reach a situation that is better to avoid, which is giving iron through intravenous infusion or giving blood doses. The accepted recommendation is to take an iron supplement with fewer side effects reported in the digestive system, which will be easy for the woman to take and stick to. Among the types of iron supplements available, absorption is particularly high in liquid iron.
How do you know how much iron to take?
A uniform dosage is usually recommended at the beginning, and later it is updated according to the level of iron in the stores, and the level of hemoglobin. It is important to emphasize that iron has a tendency to cause constipation, abdominal pain, a change in the color of the stool and sometimes even nausea. For this reason, many women stop taking iron during pregnancy – but this may have consequences later on.
What iron supplements are there on the market?
There is a wide variety of types of supplements: tablets to swallow, powders or iron in a liquid that is absorbed relatively quickly in the body. Every woman should find the preparation that is easiest for her to bear in terms of the side effect profile – so that she will continue to take it.
The author is Professor Osnat Walfish, director of the Helen Schneider Women’s Hospital at the Rabin Medical Center