Anemia in Pregnancy

Abstract

Hemodynamic changes occur in pregnancy to prepare for expected blood loss at delivery. Physiologic anemia occurs in pregnancy because plasma volume increases more quickly than red cell mass. Anemia is most commonly classified as microcytic, normocytic, or macrocytic. Iron deficiency anemia accounts for 75% of all anemias in pregnancy. Oral iron supplementation is the recommended treatment of iron deficiency anemia in pregnancy. Parenteral iron and erythropoietin can also be used in severe or refractory cases. Outcomes and treatments for other forms of inherited and acquired anemias in pregnancy vary by disease, and include nutritional supplementation, corticosteroids, supportive transfusions, and splenectomy.

Iron Deficiency Anemia in Pregnancy

“…It is assumed that iron and folate deficiency are the most common etiological factors responsible for this situation [2,3]. Anemia of pregnancy is not merely common in these countries, it is also frequently severe.…”

Intestinal hephaestin potentiates iron absorption in weanling, adult, and pregnant mice under physiological conditions

“…1 Maintaining body iron levels within the normal range is necessary to prevent iron deficiency and iron overload. Iron deficiency has numerous underlying causes, in addition to dietary insufficiency, [2][3][4] and excess iron can potentiate the formation of highly reactive oxygen free-radicals. 5 Importantly, humans do not possess a regulated excretory system for iron, and therefore, overall body iron balance is maintained by regulation of intestinal iron absorption.…”

Anemia in Pregnancy & Parenteral Iron Therapy

“…Erythropoietin with or without iron supplementation can safely be used to treat severe iron deficiency anemia in pregnancy. When compared with iron supplementation alone, the addition of erythropoietin to iron supplement has been shown to increase reticulocyte count and hematocrit faster, and decrease the time required to reach target hemoglobin levels [13].…”