Pregnancy complications

• Pregnancy complications may need special medical care.
• Common problems include anemia, diabetes and bleeding.
• Ask your provider about the signs of serious complications.

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Anemia occurs when the number or size of a person’s red blood cells are too low. Red blood cells are important because they carry oxygen from your lungs to all parts of your body. Without enough oxygen, your body cannot work as well as it should, and you feel tired and run down.
Anemia can affect anyone, but women are at greater risk for this condition. In women, iron and red blood cells are lost when bleeding occurs from very heavy or long periods (menstruation).

Anemia is common in pregnancy because a woman needs to have enough red blood cells to carry oxygen around her body and to her baby. So it's important for women to prevent anemia before, during and after pregnancy. Women will probably be tested for anemia at least twice during pregnancy: during the first prenatal visit and then again between 24 and 28 weeks.

Causes of anemia

Iron deficiency
Usually, a woman becomes anemic (has anemia) because her body isn’t getting enough iron. Iron is a mineral that helps to create red blood cells. About half of all pregnant women don’t have enough iron in their body (iron deficiency). In pregnancy, iron deficiency has been linked to an increased risk of preterm birth and low birthweight.

Illness or disease
Some women may have an illness that causes anemia. Diseases such as sickle cell anemia or thalassemia affect the quality and number of red blood cells the body produces. If you have a disease that causes anemia, talk with your health provider about how to treat anemia.

Signs of anemia
Anemia takes some time to develop. In the beginning, you may not have any signs or they may be mild. But as it gets worse, you may have these symptoms:

• Fatigue (very common)
• Weakness (very common)
• Dizziness
• Headache
• Numbness or coldness in your hands and feet
• Low body temperature
• Pale skin
• Rapid or irregular heartbeat
• Shortness of breath
• Chest pain
• Irritability
• Not doing well at work or in school

Because your heart has to work harder to pump more oxygen-rich blood through the body, all of these signs and symptoms can occur.

Getting enough iron
Before getting pregnant, women should get about 18 milligrams (mg) of iron per day. During pregnancy, the amount of iron you need jumps to 27 mg per day. Most pregnant women get this amount from eating foods that contain iron and taking prenatal vitamins that contain iron. Some women need to take iron supplements to prevent iron deficiency.

Iron-rich foods
You can help lower your risk of anemia by eating foods that contain iron during your entire pregnancy. These foods include:

• Poultry (dark meat)
• Dried fruits (apricots, prunes, figs, raisins, dates)
• Iron-fortified cereals, breads and pastas
• Oatmeal
• Whole grains
• Blackstrap molasses
• Liver and other meats
• Seafood (learn about the safe kinds of seafood you can eat during pregnancy)
• Spinach, broccoli, kale and other dark green leafy vegetables
• Baked potato with skin
• Beans and peas
• Nuts and seeds

Foods containing vitamin C can increase the amount of iron your body absorbs. So it's a good idea to eat foods like orange juice, tomatoes, strawberries and grapefruit every day.

Coffee, tea, egg yolks, milk, fiber and soy protein can block your body from absorbing iron. Try to avoid these when eating iron-rich foods.

Iron supplements
If you are anemic, your health care provider may prescribe an iron supplement. Some iron supplements may cause heartburn, constipation or nausea. Here are some tips to avoid or reduce these problems:

• Take the pills with meals.
• Start with small doses and work your way up to the full dose slowly. For example, try taking one pill a day for a few days, then two pills until you aren't bothered by that amount. Increase the number of pills until you're taking the amount your health care provider recommends.
• Try different brands to see which works best for you. Be sure to discuss any changes with your health care provider ahead of time.
• Avoid taking iron pills at bedtime.

Reduce constipation by drinking more water and by eating more fiber. Fiber is found in whole grain foods, breakfast cereals, fruits and vegetables.

April 2009