Why iron is crucial during pregnancy

Iron deficiency during pregnancy can have significant effects on your baby's development. A Mediclinic expert explains why, and what to do.

Why your body needs iron

Iron is a fundamental mineral in the human body. It’s important for your body to function normally and is involved in oxygen transport, energy production and your immune system. Iron is necessary to produce haemoglobin, the oxygen carrier of the human body. “It’s also used in producing the chemicals in your brain that transmit signals between nerve cells in the brain,” says Dr Anel Mostert, an obstetrician and gynaecologist at Mediclinic Kloof. “These neurotransmitters are used in brain functions such as learning, memory, and mood regulation.”

Iron deficiency is the most common nutrient deficiency worldwide. Symptoms include unusual food cravings, headaches, restless legs, poor concentration, fatigue, and light-headedness. Iron also plays a crucial role in the brain development of an unborn child.

People who don’t consume enough iron may experience iron deficiency (ID) or iron deficiency anaemia (IDA). Anaemia is a common disorder during pregnancy – the World Health Organization (WHO) estimates up to 40% of pregnant women in the world are anaemic during their third trimester.

“Anaemia and low iron levels during pregnancy are potentially harmful to your unborn child,” cautions Dr Mostert. “When the mother is deficient in iron, it can lead to reduced oxygen supply to the foetus, affecting the growth and development of the baby's brain. This may increase the risk of neurodevelopmental disorders, cognitive impairments, and behavioural problems in the child later in life.

“That’s why it's important for pregnant women to address iron deficiency through proper iron supplementation and dietary changes that support both their own health and the healthy development of their baby's brain.”

Iron intake during pregnancy

The recommended dietary iron intake for women aged 19-50 is 18mg of iron daily. During pregnancy, the recommended amount increases to 27mg. This is to support the increase in demand for maternal blood volume and that of the growing foetus. The increase in maternal red blood cell volume prepares the mother’s body for the blood lost during delivery. “A woman’s iron usage increases sevenfold when she is pregnant,” Dr Mostert explains.

Many women start their pregnancy journey with deficient iron levels. This is often caused by recent pregnancy and childbirth, poor diet, or heavy menstruation prior to pregnancy. “Unfortunately, it’s almost impossible to replenish your iron levels if you start a pregnancy with an iron backlog,” she says.

Women with average periods lose about 15-20mg of iron per cycle. This explains the high prevalence of iron deficiency in women who experience heavy menstruation, as they lose six times more iron than those who have “normal” menstrual blood loss. Dr Mostert says almost a third of teenagers who experience heavy menstruation have low iron levels. “This is because there’s no point of reference as to when periods are classified as ‘heavy’, and they perceive these heavy bleeds as normal,” she explains.

Low iron risks to mother and baby

It’s vital to treat low iron and haemoglobin levels during pregnancy, as these pose several risks to mother and baby:

Mother

• Anaemia
• Preterm birth
• Fatigue
• Decreased productivity
• Difficulties breastfeeding
• Postpartum depression
• Bleeding during delivery and the need for blood transfusion

Baby

• Low birth weight
• Impaired cognition
• Delayed milestones

Getting adequate iron in pregnancy

Although foods like beef, seafood, poultry, grains, nuts, seeds, and legumes are high in iron and should form part of your diet, Dr Mostert says it’s still important to take supplements. “While consuming iron-rich foods is important during pregnancy, it can be challenging to meet the increased iron requirements through diet alone – especially for women who have preexisting iron deficiency or difficulty absorbing iron.”

Prenatal multivitamins usually contain iron, along with other essential nutrients for pregnancy. The dosage of iron may vary depending on individual factors such as iron status, dietary intake, and health history. If you’re pregnant or are planning to fall pregnant, it’s important to discuss this with your healthcare professional.

To find an obstetrician-gynaecologist near you, go to www.mediclinic.co.za.

“Planning your pregnancy has many benefits,” explains Dr Mostert. She recommends ensuring that iron levels are optimal before falling pregnant, especially for women who have heavy periods. “Oral iron supplementation before pregnancy is a good idea,” she says, “especially since many women fail to consume the recommended daily amount. European studies show the average daily consumption of iron is approximately 14mg, which is way below what it should be. Unfortunately, we don’t have similar figures available for South Africa, we can assume that it’s lower, because of our socio-economic profile.”

Iron levels can be tested during pregnancy, however, it’s important to remain alert to symptoms that may indicate deficiency. These indicate dizziness, tiredness, irritability, poor sleep and poor concentration. These symptoms should be reported to your healthcare provider as soon as possible, so that they can test for depleted iron stores and correct levels with appropriate treatment.