-
Iron requirements in pregnancy are increased greatly, especially
after the first trimester
-
The body's iron absorption ability greatly increases as pregnancy
progresses
-
There is a significant association between poor perinatal
outcomes and moderate anemia
-
Iron supplementation alone may not correct anemia if other
nutrient deficiencies exist as well and are not corrected
-
Severe anemia (mostly in the developing world) may result
in death from hypoxia (lack of oxygen) and heart failure
-
Iron supplementation does not increase hemoglobin higher than
the optimal amount needed for oxygen delivery
-
Current practices of iron supplementation are note based on
improved outcomes, but simply on elevating hemoglobin to its
supposed 'optimal' level
-
Chronic inflammation may contribute to anemia, since in one
study, up to 73% of anemic women had elevated levels of C-reactive
protein
-
Folate, vitamin B12, and vitamin A deficiencies, in addition
to iron, are common in anemic women.
Although elevated hemoglobin is often viewed as a good sign, this
is not necessarily the case:
-
High hemoglobin concentration may erroneously be mistaken
as signifying adequate iron status
-
High hemoglobin is actually associated with poor pregnancy
outcomes, possibly due to increased blood viscosity, which impedes
proper oxygen delivery
-
High hemoglobin should be regarded as signal of a possible
pregnancy complication
According to one published estimate, the iron requirements during
pregnancy are as follows:
-
1st Trimester - 0.8mg daily
-
2nd Trimester - 4 to 5mg daily
-
3rd Trimester - 6mg daily
During the 3rd trimester it is almost impossible to get enough
iron from the diet, which means that the mother's iron stores will
be drawn upon to meet the demand.
The total iron requirement for a normal pregnancy in an average
size woman is approximately 1,000mg
American Journal of Clinical
Nutrition July, 2000 supplement