Iron Deficiency and Treatment in Indian Pregnant Women

It is a matter of concern because maternal anemia is the cause of death of 18% children in the womb or while birth and death of 20% of mothers during or while giving birth in South Asian countries including India. Awareness and education about Iron deficiency is the only way to tackle this problem.

Anemia is a condition where the red blood cell number or their oxygen carrying capacity is insufficient to meet the physiologic needs, and is conventionally taken as Hemoglobin (Hb) value that is less than two standard deviation below the median value for healthy matched population by age, sex, altitude and pregnancy status. 

Iron Deficiency Anemia (IDA) continues to be the commonest etiology of anemia in pregnancy. The prevalence of IDA in pregnant Indian women is amongst the highest in the world. Untreated iron deficiency has adverse feto-maternal consequences. Therapy for ID includes dietary modification and oral iron supplementation, intravenous iron and blood transfusion. Despite major reforms in the health sector in the past century iron deficiency continues to be in epidemic proportions in pregnant women, especially, in India. Many ways have been recommended for increasing public awareness and tackling this health issue including the observance of ‘National Anemia Awareness and Treatment Day’.

The cause of iron deficiency in pregnant women can be numerous. They can range from not being able to intake proper diet needed for a pregnant woman, other medical and environmental conditions in which the pregnant woman is living. Apart from the woman herself, it is the effort of family and society, which leads to a good development of child in womb as well as good health of the prospective mother.

There should be a screening of anemia during pregnancy in the first trimester of pregnancy then at 24th t0 28th week then at 36th week of gestation. On consultation of the doctor, a diet rich in iron should be followed upon detection of ID and if there isn’t then also a balanced diet should be followed apart from the supporting vitamins and iron plus folic acid pills prescribed by the doctor. Any carelessness in this respect can affect the overall health of the mother and the child including their immune system. Even if you are leading healthy lifestyle with exercise, iron deficiency can be detected in you, which requires regular check-ups and supplementations at times to maintain good health throughout the pregnancy. During pregnancy the extra demand of iron of the body is not met by regular diet and hence iron supplementation becomes a must.

The recommended dietary allowance (RDA) of iron in third trimester is 30mg/day. The average iron density in an average Indian diet is 8.5mg/1000KCal and the average iron absorption from a rice based and wheat based Indian diet in pregnancy is 13.3% and 5.3% respectively. Dietary modification to meet the demands of the body is cheap and culturally acceptable. However, considering the Indian food practices, dietary modifications are likely to be inadequate and most pregnant women require supplementary iron. Apart from dietary modifications, if you are diagnosed with ID during pregnancy then the treatment includes oral iron supplementation in moderate ID. The Ministry of Health and Family Welfare guidelines for treatment of IDA in pregnancy continues to recommend intra-muscular (IM) treatment following a test dose for moderate ID. However, IM treatment has been essentially replaced by intra-venous (IV) because IM route is a painful injection, there is risk of myalgia and arthritis as well.

Hence, it is important for pregnant women to be aware and regulate their diet. They must eat iron rich foods like banana, apple, pomegranates, legumes and green-leafy vegetables, etc. Apart from that doctor’s recommended iron plus folic acid supplementation is a must. If detected with ID, they must follow the treatment prescribed by the doctor and there should regular check-ups to ascertain adequate iron levels.

References

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About The Author

Rajul Tiwari

Rajul Tiwari is the Editor-in-Chief at bodyandstrenth.com and has 18 years of experience in media, content, publishing and education. She has worked with media houses like Daini.... Read More..

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