Why is it important to prevent anaemia in pregnancy?

Anaemia in pregnancy is still a major health problem in Nigeria, especially among new mothers. Besides, experts warn that it is important that women prevent anaemia in pregnancy because it affects both the growth of their babies before they are born and afterwards, reports Sade Oguntola.

Many pregnant women feel reluctant taking folic acid and iron tablets, a common prescription by doctors. The usual excuse is that they are not sick and it is not important that these drugs be taken every day. But the worsening economic situation of many families and lack of consumption of leafy vegetables and a balanced diet, can all combine to make women give birth to low birth weight infants due to anaemia. Anaemia is a major hazard during pregnancy, especially in the last trimester of pregnancy. This is a condition in which you don’t have enough red cells in your blood. Red blood cells contain haemoglobin, which carries oxygen from the lungs to the rest of the body. If a person’s haemoglobin level is very low, the body tissues will not be getting enough oxygen. About 40 per cent of pregnant women worldwide are estimated to be anaemic, and iron and folic acid supplementation during pregnancy is commonly prescribed to prevent anaemia in pregnancy, which is often caused by iron deficiency. During pregnancy, there is high iron requirement, almost three times required for non-pregnant women of childbearing age, which is difficult to meet from dietary sources. Also, anaemia, caused by iron deficiency alone or in combination with other factors such as folic acid or vitamin A deficiency and malaria, has several negative effects on the pregnant woman and her unborn child. The benefits of iron and folic acid supplementation surpass what was previously perceived by many people. According to a new study that analysed the long-term effects of iron and folic acid supplementation in pregnancy on childhood survival, the use of these supplements during pregnancy ensures that babies are healthy and better protected from diseases during childhood. The researchers from Johns Hopkins Bloomberg School of Public Health suggested that taking folic acid and iron supplements in pregnancy might reduce infant mortality by 31 per cent in children less than age seven. What is more, intakes of these medicines reduced the occurrence of low birth weight by 16 per cent and anaemia in a pregnant woman and after the birth period by 50 per cent. This was a study that recruited almost 5,000 pregnant women in rural Nepal to take part in the randomised, double-blind, controlled trial. The women were divided into five groups: one group received folic acid only; the second group received folic acid plus iron; the third received folic acid plus iron plus zinc; the fourth received multiple micronutrients and the final group received vitamin A and acted as the control group. It was a follow-up to a 1999 to 2001 trial of the administration of micronutrients to women during pregnancy. Out of the 4,130 babies born alive, 209 died in the first three months and eight were lost to follow-up. Of the 3,761 remaining, the researchers report in the American Journal of Epidemiology that 150 died between the ages of three months and seven years, while 152 were lost to follow-up. Given a 31 per cent increase in childhood survival, due to intakes of iron and folic acid tablets, both during and after pregnancy, they declared that this should provide additional motivation to increase global programmes for antenatal iron and folic acid supplementation. Dr Kayode Afolabi, a consultant obstetrician and gynaecologist, explained that anaemia was a serious hazard both to the pregnant woman and her unborn baby because of its complications. “If you look at the mother who is anaemic during pregnancy, such a woman is bound to have repeated infections, including malaria, because her body immunity is lowered. Due to the fact that they tolerate many undercurrent diseases much more easily, they stand a higher risk of experiencing more ill healths and even deaths than the average pregnant woman that is not anaemic,” he stated. Dr Afolabi pointed out that low blood level in a pregnant woman is not good for the unborn baby either. According to him, “anaemia in pregnancy is a known cause of abortion, restricted growth of the baby in the womb; low birth weight and even the death of the baby that is still in the womb. If there is restriction in the growth of the organs of the body, including the brain, when such a baby is eventually born, such may not grow to their full mental potential.” What accounts for anaemia in pregnancy? According to the expert, “in this environment, we have malaria in pregnancy as a major problem. It causes the breakdown of red blood cells in the body. Also, it depresses the bone marrow from producing more red blood cells to meet the demand of pregnancy, hence leading to an anaemic state.” In addition, he mentioned other causes of anaemia in pregnancy as urinary tract infection and chest infection as well as poor diet (what is termed nutritional anaemia). What is, however, worrisome according to Dr Afolabi is that “most of our women, in fact, start pregnancy with less than optimal nutritional status and their condition is made worse by the demands of the unborn baby, the placenta cord attaching the baby to the mother and even the body’s preparation for breast milk production.” While this could contribute to such women becoming anaemic in pregnancy, he pointed out that many dietary practices in Nigeria further accentuated the problem. “Things like overcooking of vegetables lead to loss of folic acid,” he declared. Meanwhile, Dr Afolabi declared that the routine prescription of iron and folic acid tablets to pregnant women after 12 weeks of pregnancy was aimed at providing extra supply of these essential ingredients for blood formation, as well as meeting the demands of the baby, placenta and even prepare the woman for breast milk production afterwards. He said that the use of iron and folic acid tablets in pregnancy could help to improve child survival, considering that the baby would have access to adequate micronutrients in the womb and the baby would develop sufficiently to meet the challenges of early life. He declared: “Such a baby would have good body immunity, have good body weight and the vital organs in the body would also develop optimally, thus ensuring that during childhood, such a baby would be able to cope better with the challenges of health. Since, the mother is adequately prepared for breast milk production, the baby’s intake of breast milk would boost the body immunity and reduce risk of diarrheal disease, a major killer of children.” Given that many pregnant women do not conform to their doctors’ instructions to take iron and folic acid tablets, he emphasised the need for educating women on the importance of taking these medicines. “It could be a bit difficult if a woman does not understand why she must take these medicines three times in a day, throughout the period of pregnancy, when she is not sick,” he declared. For a healthy pregnancy, he advised that pregnant women should book for antenatal care early, rest, eat a balanced diet, maintain good personal hygiene and stick to other advice they are given by their doctors. http://www.tribune.com.ng/index.php/your-health/46746-why-is-it-important-to-prevent-anaemia-in-pregnancy-