As far as preventing iron-deficiency anaemia is concerned, the advice to take oral iron supplements is specially relevant for vegetarians. This can be done even before there is detectable iron deficiency.
With the fall in haemoglobin (Hb) concentration, the capacity to carry oxygen is reduced. This is not the only problem, though.
Iron is crucial in the production of a variety of critical enzymes in the body. The production of these will be affected, too. As a result, various body systems may be affected. These may include the brain and nerves, muscles, the gut and the skin. There is reduced exercise tolerance and even the common chores that you may be used to doing without a second thought become increasingly hard to cope with. There is general and almost constant lethargy and fatigue.
Yes. There is fairly strong evidence that iron deficiency can lead to preterm labour.
What about the effect of iron deficiency on labour?
Iron deficiency has no direct effect on labour as such. However, a woman who is anaemic when going into labour will tolerate badly any blood loss, an inevitable occurrence at delivery. Normally, a mother can take blood loss of up to 1000 ml (one litre) in her stride. A markedly anaemic woman may find this to be a tall order and it could create a life-and-death crisis.
There is also evidence, though not very strong, that iron deficient women are more prone to heavy bleeding at delivery (postpartum haemorrhage), the very complication they are ill-equipped to deal with.
Anaemia in pregnancy does also rob the affected women of options that, like everybody else, they might be interested in options like home delivery or, where available, maternity homes and cottage hospitals for delivery. With anaemia, these will no longer be options because of the potential risks, which such places cannot cope with.
Yes. When maternal iron stores are depleted, the levels of iron in the fetus will also end up being lower than normal, for obvious reasons. It follows that these babies will be more prone to develop anaemia within the first year of life. Other collateral effects include the child's increased susceptibility to infections.
This is easily done by estimating the levels of a certain blood protein called Ferritin. This protein accurately reflects the long-term iron store levels.
Except for those women who have specific conditions that contraindicate use of iron supplements, everybody else will benefit from oral iron supplements in pregnancy, some more so than others.
For those who embark on pregnancy with a good haemoglobin level and with good iron stores, the iron supplements may not give any clinically apparent benefit. They will, nonetheless, allow for maintenance of healthy iron stores, allowing for optimal production and function of various essential enzymes in all body systems. That state will also mean a continued general well-being. Such a woman can and will tolerate unduly heavy blood loss much better. She will also go into the postnatal period a healthier person, better placed to face the challenges of new motherhood.
For women who are total vegans and those who embark on pregnancy while already anaemic or with low iron stores, the taking of oral iron supplements is imperative.