Anemia in Pregnancy : Symptoms, Causes, Diagnosis, Drugs for Treatment and Prevention


Anemia in Pregnancy: how does it manifest itself?

Pregnancy anemiaIn the early stages of anemia, non-specific or poorly evident symptoms may arise, so much so that they can be confused with those that accompany a normal pregnancy. To confirm anemia it is therefore necessary to undergo routine blood tests during prenatal tests. Doctors usually perform various tests to check the percentage of red blood cells in the plasma, the concentration of hemoglobin and the value of other indicators, in order to evaluate whether the patient is, or risks becoming, anaemic.
The most common symptoms of anemia during pregnancy are:

Risks connected to Anemia in Pregnancy

During pregnancy, theiron deficiency anemia severe or untreated may increase the risk of:

Furthermore, the child may suffer from anemia during childhood and, in more severe cases, may have constitutional or cerebral growth retardation.

Folate deficiencies And of vitamin B12 untreated can increase the risk of having a:

  • Preterm or low birth weight newborn;
  • Child with birth defects, especially affecting the spine or brain (neural tube defects).


Anemia in Pregnancy: which tests are useful?

The diagnosis is based on the presence of clinical symptoms typical of anemia and on the outcome of laboratory investigations.
During the first prenatal visit, the doctor can use a blood test to check whether the future mother suffers from anemia.
The diagnosis begins with a blood exam completed (CBC, Complete Blood Count).
The following parameters are determined with the blood count test:

  • Hematocrit value (Htc): measures the percentage of the plasma volume occupied by erythrocytes and is generally decreased in the evaluation of a possible anemic state;
  • Sideremia (indicates iron deficiency) e serum ferritin (indicates the extent of iron deposits in the body, if less than 10 mg/L requires treatment): to check the availability of iron in the body.
  • MCV (Mean Corpuscular Volume): indicates the size of the red blood cells, highlighting whether they are smaller than normal (microcytic anemia) or larger (macrocytic anemia).

The assessment may also include:

Even when anemia is not found early in pregnancy, your doctor may recommend subsequent blood tests to check for anemia in the second or third trimester of pregnancy.

Criteria to define anemia in specific stages of pregnancy:


Quarter Hemoglobin (g/dl) Hematocrit (%)
First <11 <33
Second <10.5 <32
Third <11 <33
  • Under normal conditions, any woman who has a hemoglobin (Hb) concentration lower than 12 g/dl is considered anemic;
  • During pregnancy, the diagnosis of anemia is based on Hb values
  • If at the beginning of pregnancy the Hb is less than 11.5 g/dL, women can be subjected to prophylaxis, since the subsequent haemodilution usually tends to reduce the Hb value below 10 g/dL dL.

PLEASE NOTE: the lower limits of normality may vary slightly from laboratory to laboratory; furthermore, in order to talk about actual anemia, it is important to evaluate the overall results of the blood test, cross-referencing the values ​​of several blood indices.


Anemia in Pregnancy: what is the expected treatment?

The main goal of treatment is to reverse the anemia.

A balanced diet it is generally sufficient to ensure the supply of iron and other nutrients. The doctor may also recommend enriching the diet with foods high in iron, vitamin B12 and folic acid, such as:

Foods of animal origin contain iron that is more easily assimilated by the body than vegetables. Iron absorption increases when associated with iron-rich foods C vitamin (example: citrus fruits, kiwi…). When, however, severe anemia is linked to different factors, not associated with nutritional deficiencies, it is necessary to resort to iron and/or folic acid supplementsin addition to prenatal vitamins to complement the diet. There oral therapy it is the first line of treatment: prophylaxis with low doses of iron, combined with folate, is recommended. These supplements can cause some unwanted effects: heartburn, heaviness, constipation or, conversely, intestinal hypermotility. In these cases, it is best to take them on a full stomach to alleviate the discomfort (even if this could reduce the absorption of the active ingredients) and always inform your doctor of any discomfort felt. Also to treat the vitamin B12 deficiencyyour doctor may recommend taking a supplement.

There transfusion it is indicated for any anemia associated with severe constitutional or cardiopulmonary symptoms (e.g., dyspnea, tachycardia, tachypnea).
After a certain period of time, the patient is invited to undergo another blood test to evaluate whether the hemoglobin levels and hematocrit have improved. The same check is indicated 4-6 weeks after giving birth.

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