Preserving a Mother’s Healthy Glow: What Women Need to Know Before, During and After Pregnancy

Blood the most important element in ensuring a healthy positive pregnancy experience!

Feeling tired; sick, irritable or weak during pregnancy is a common occurrence for most women. Often, women generally are told to ignore these symptoms as they are a ‘normal’ part of the hormonal and bodily changes during pregnancy – but for one in three women, these conditions could indicate a more severe disorder: iron deficiency anemia.

With 1 in 3 pregnant women suffering from iron deficiency anemia¹ in Malaysia, this condition is more common than most women may be aware of. Nevertheless, this health problem is not normal, and it often goes undiagnosed and untreated – leaving many mothers and babies grappling with long term health consequences.

Division Director of Merck Consumer Healthcare, Mr Richard Lee and Consultant Obstetrician & Gynecologist, Dr Premitha Damodaran, come together to raise awareness about iron-deficiency anemia in pregnant and post pregnant women at a recent media workshop.

In an effort to heighten public awareness about iron deficiency anemia in pregnant and post pregnant women, Merck Consumer Healthcare recently hosted an educational workshop together with Dr Premitha Damodaran, a leading Consultant Obstetrician & Gynecologist with more than 15 years experience in her field of expertise.

Consultant Obstetrician & Gynecologist, Dr Premitha Damodaran

Themed ‘Pregnancy and Anemia: More Common than You Think. Insights into Preserving Mother’s Healthy Glow’, Dr Premitha was on hand to address the key issues of anemia and to share her advice on coping with anemia before a woman conceives, during pregnancy and after delivery.

Division Director of Merck Consumer Healthcare, Mr Richard Lee

“At Merck Consumer Healthcare, we understand that anemia can seriously impact a woman and her baby’s quality of life especially during pregnancy. In order to better gauge the understanding of Malaysian in general on the topic, we recently ran a vox pops survey and were shocked to discover that most women did not even know about iron-deficiency anemia during pregnancy. Upon realizing that the awareness level was dismally low, we committed ourselves to enhancing the health and wellness of Malaysian mom by organizing a media education workshop on the topic.”

“For that we are grateful to have a vocal advocate on women’s health issues Dr Premitha Damodaran to present this workshop aimed at fostering a greater understanding on iron-deficiency anemia and pregnancy,” said Mr Richard Lee, Division Director of Merck Consumer Healthcare Malaysia during his welcome note.

“Ultimately, I believe this workshop will help us reach out to all women and impart them with vital awareness and knowledge on the condition and help with preparing them for an optimal, and healthy pregnancy by caring for their blood.” added Mr Lee.

Key issues of anemia in pregnancy were addressed in the workshop by Dr. Premitha Damodaran, a leading Consultant Obstetrician & Gynecologist with more than 15 years experience in her field of expertise

Functions of Blood and Anemia

Iron comprises a vital component of our red blood cells, delivering vital oxygen through our body to ensure continued survival.  According to Dr Premitha, women who are at risk of anemia and considering pregnancy need to start planning and caring for their pregnancy and postpartum by taking the necessary measures to ensure that they have an optimal red blood cell count.

When the number of red blood cells falls below normal levels (< 12-15mg/dl) women are at risk of developing the most common form of anemia - iron deficiency anemia.  This condition arises when the body lacks iron as a result of an iron-poor diet, poor absorption by the body, side effects of certain medications, genetic conditions, heavy loss of blood and pregnancy.

Relationship between Anemia and Pregnancy

During pregnancy women require additional iron to make more red blood cells to support the nutrition and oxygen needs of themselves and their baby. It is estimated that a woman requires to approximately 50% more iron during pregnancy; increasing the daily standard requirement from 15 to 27mg/dl per day.

Unfortunately, many women begin their pregnancy without having sufficient stores of iron to meet their body’s increased demands for iron, leading to iron deficiency anemia; which continues even after delivery. Those who are at highest risk of iron deficiency anemia after pregnancy include pregnant women diagnosed with iron deficiency anemia, those who have experienced excessive blood loss during delivery, women who have experienced multiple births and those who are breastfeeding.

Symptoms and Impacts of Anemia on Pregnancy

Because the symptoms of anemia resemble common conditions encountered during pregnancy like paleness, tiredness, fatigue and shortness of breath most women often disregard these symptoms and think it as a normal part to carrying a baby to term. However, if not indentified and treated, iron deficiency anemia can lead to severe complications like miscarriage, premature delivery, low birth weight and increased maternal mortality.

Prevention and Management of Anemia – Diagnosis

Microscopic view of blood sample showing normal amount of red blood cells

Microscopic view of blood sample of Anemic person showing low levels of red blood cells

Anemia during pregnancy is easily established through a diagnosis process which starts by firstly determining the levels of hemoglobin in the body via a blood test. It is recommended that prior to pregnancy for a woman to speak to their doctors and assess the level of hemoglobin in their bodies. Unfortunately, most times women only see their doctors once they are pregnant and by the time their blood test is done, most are already found to be suffering from mild anemia.

Severity	Hemoglobin Concentration (g/dL)
Classification of Anemia	Pregnant women
Normal	>11.0
Mild	9.0 - 11.0
Moderate	7.0 - 8.9
Severe	<7.0

In more severe cases, medical attention is required as these groups of women are at risk of having a premature delivery and getting a baby with low birth weight.

Prevention and Treatment

Depending on the severity and cause of anemia, treating this condition requires little more than following your doctor’s advice and making some simple diet and lifestyle changes. To boost iron supplies when you are trying to conceive, during pregnancy and breastfeeding, women are encouraged to increase intake of iron-rich foods such as poultry, green leafy vegetables, nuts, liver, whole grains, dried fruits such as prunes and raisins, beans, melons, seeds like sesame, and tofu.

Doctors also routinely prescribe iron supplements to treat anemia. Patients are recommended to choose an iron formulation that their body can tolerate in order to optimizing absorption of iron into the body, this helps with reducing common side effects like constipation. Women who are at risk for anemia can also consider choosing iron supplement with flavored coating to help mask the metallic taste.

To optimize the effectiveness of iron therapy, it is also recommended that mothers consume iron, folate, copper and zinc supplements with food to reduce inhibitory effects. A Vitamin C supplement is recommended to be taken with meals as it is known to increase iron absorption² whereas tea and coffee reduce iron absorption if consumed one or two hours before taking iron supplement³.

A calcium supplement is also recommended to be taken separately from iron such as during bed time to reduce inhibition of iron absorption⁴. Women should continue to take iron-rich food and supplements until they stop breastfeeding or for 6 months after delivery whichever comes later.

In severe and life threatening anemia, a woman may require hospitalization, blood transfusions, and iron injections.

Consultant Obstetrician & Gynecologist, Dr. Premitha Damodaran shares some insightful opinions and recommendations on what women need to know before, during and after pregnancy.

“Women should always also ensure that their blood is healthy by conducting blood test when they plan to get pregnant, during pregnancy and four to six weeks after delivery. They can always stay on top of their game by acquiring a sufficient amount of iron from daily dietary and supplementation that help increase blood hemoglobin levels. Please seek immediate medical assistance if any of the above conditions are present,” advised Dr Premitha.

Merck Consumer Healthcare recognizes the evolving role of medicine to encompass a wider scope of health and wellness. Driven by the belief that preventive medication is a part and parcel of everyday living, Merck Consumer Health Care continues to improve and transform lives with innovative healthcare solutions.

AN EDUCATIONAL INITIATIVE FROM MERCK

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1.  Zulkifli A, Rogayah J, Hashim MH. Anaemia during pregnancy in rural Kelantan. Mal J Nutr. 1997; 3: 83-90.

2.  Sandstrom B.Micronutrient Interactions: Effects on absorption and biovailability.British Journal of Nutrition 2001; 85(2):181-185

3.  Stolzfus RJ, Dreyfuss ML. Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. International Nutritional Anemia Consultative Group (INAGG). http://www.who.int/nutrition/puloblications/micronutrients/guidelines_for_iron_supplementation.pdf

4. Clinical practice guidelines. The management of anemia in pregnancy and chronic kidney disease. Academy of Medicine of Malaysia. 2007.