Iron deficiency anaemia affects 42% of pregnant people. Without adequate iron stores, anaemia can develop that effects the mother and unborn child. Iron is needed to form all body cells, building the placenta, increasing maternal iron stores and of course creating all tissues in the unborn child.
Iron forms part of proteins involved in DNA synthesis and energy production, giving women strength and energy through pregnancy and postpartum. Iron is needed for placental function and oxygenation and to reduce miscarriage risk
Positive effects of iron in pregnancy
- Cognition in the mother and baby: Iron is required to bring oxygenated red blood cells to the brain. As the brain develops, it requires iron for building new brain cells and the nervous system.
- Fetal brain and organ development: Iron is important for the metabolism and function of nerves in the brain, affecting babies brain function post-birth. During fetal development, iron-dependent enzymes are essential for organ development, particularly the brain, through myelination of nerve cells, neurotransmitter synthesis and gene expression.
- Immunity: Iron increases the functions of immune cells and regulates enzymes that control the production of antimicrobial cells.
- Reduced risk of antenatal and postnatal depression: Iron prevents depression and anxiety through adequate neurotransmitter metabolism and myelination of nerves in the brain of the mother.
- Increased exercise capacity: Iron is a part of red blood cells, transporting oxygen to tissues and is a cofactor in aerobic metabolism, increasing exercise capacity for the mother.
- Preterm birth prevention: Adequate levels of iron rich haemoglobin reduce the chance of hypoxia induced stress response and oxidative damage in utero.
How much iron do you need?
Blood volumes increase by 40-50% by the 24th week of pregnancy, meaning an increased demand for iron. Below are the recommended dietary intakes of iron for pregnant and non-pregnant women.
|Pregnant women||Non-pregnant women|
|14-18 years||27 mg/day||15 mg/day|
|19–30 years||27 mg/day||18 mg/day|
|31-50 years||27 mg/day||18 mg/day|
Consequences of iron deficiency in pregnancy
- Symptoms in the mother: reduced cognition, pale skin, irritability, breathlessness, heart palpitations, hair loss, tinnitus, headaches and dizziness.
- Consequences for the pregnancy: As the need for iron progresses, the pregnancy is effected with increased risk of premature delivery, intrauterine growth retardation, gestational diabetes, preeclampsia, postpartum haemorrhage, birth asphyxia and even infant and/or maternal death.
- For the fetus: Iron deficient neonates can have a lower birth weight, have significantly reduced cognitive abilities and behavioural abnormalities that can persist even after iron repletion post-birth.
How can we prevent iron deficiency in pregnancy?
- Some forms of iron in food are more readily absorbed, for example the iron from meat has better absorption than plant sources of iron. A diverse diet of meat and vegetables together is recommended to increase iron levels in pregnancy.
- Vegan and vegetarian mothers are more at risk of iron deficiency than meat eaters, as are women from limited socioeconomic backgrounds. Teen-mothers are also at a higher risk due to the iron needs for their own growth. If you are at risk, more frequent check-ins with your healthcare team is warranted to reduce chances of iron deficiency.
- Reach the RDI by eating a variety of iron rich foods throughout pregnancy.
- Legumes, rice and beans can bind to iron, therefore avoid intake of supplements at the same time.
- Intake of iron can be increased by taking it at the same time as vitamin C.
- See your doctor to get blood tests during preconception and throughout pregnancy to determine if you have iron deficiency.
- Do not supplement iron without first being tested for deficiency, as high iron can have detrimental effects to mother and baby.
- If you are severely deficient in iron, an intravenous iron transfusion can be used in the third trimester of pregnancy to bring iron levels to within range.
- Space out your supplement dose to 2–3 times weekly, as opposed to daily, as this is as effective as daily supplementation, with fewer side effects.
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