Published in the journal Blood Advances, a new study shows that one of every two pregnant women has low levels of iron. While the deficiency is concerning, experts note that supplements and diet can help treat low iron levels, helping parents have healthier pregnancies.

The Study

Researchers studied close to 45,000 pregnant women who had prenatal tests performed at laboratories in Ontario, Canada. They looked at the tests given between 2013 and 2018. The goal was to determine how frequently the expecting mothers had their iron levels checked. “Only 60% of women had an appropriate iron test during pregnancy; 40% did not have iron testing in pregnancy,” says Jennifer Teichman, MD, hematology resident at the University of Toronto, Temerty Faculty of Medicine, Department of Medicine, and lead author of the study. “Of those who were tested, over 50% were iron deficient, and one quarter were [iron insufficient].” Financial status played a part in whether a woman had the testing done. “We found that women of lower socioeconomic status, as represented by lower average annual household income, were less likely to have an iron test in pregnancy, compared to women of higher socioeconomic status,” says Dr. Teichman. The study data do not include details on the participants’ ethnicity and education, and also may not account for marginalized pregnant patients. Additionally, patients who received testing at certain types of facilities were excluded. The results still carry weight, however, especially in light of the fact that low iron levels are not uncommon. Approximately one-third of all women of reproductive age are estimated to be anemic, according to the World Health Organization. The American Pregnancy Association estimates that in the United States, 15 to 25% of pregnancies experience iron deficiency. While this estimate is lower than the study findings, it further illustrates the prevalence of iron deficiency during pregnancy. Given the importance of iron, the study results highlight the need to monitor iron levels during pregnancy.

Why You Need Iron During Pregnancy

Iron makes hemoglobin, which is a protein present in red blood cells. That protein then transports oxygen throughout the body. Iron also aids in growth, development, and producing energy molecules. Thus, it has a critical role in pregnancy and developing the fetus and placenta. Hemoglobin tests are a standard part of prenatal bloodwork. The tests check for anemia, which can indicate a low level of iron. Doctors do not generally perform a ferritin test, though, as part of this bloodwork. This would measure the amount of ferritin, which is the blood protein that makes iron. “Most professional guidelines recommend testing ferritin in pregnancy only when a patient is anemic—that is, when a hemoglobin test is low,” Dr. Teichman says. “However, if we wait for the patient to become anemic, we have missed the boat, and they have already become severely iron deficient.” Iron deficiency can cause a host of problems during pregnancy. Signs of not having enough iron can include shortness of breath, an irregular heartbeat, dizziness, and cold hands or feet. You may also experience headaches, difficulty focusing, and restless leg syndrome. “Low iron—anemia—puts mom at risk for prolonged labor and hemorrhage," says Gwenneth Simmonds, PhD, CNM, a certified nurse midwife specialist in Sumter, South Carolina. “She’s also more likely to be tired, weak, depressed.” Anemia during pregnancy can lead to your baby being born prematurely or with low birth weight. The iron deficiency can also impact a child in later years, potentially causing cognitive problems.

Getting Enough Iron

Avoiding iron deficiency by consuming enough of the mineral is a relatively simple fix. You can beef up your diet with iron-rich foods. Leafy green vegetables, dried fruits, lentils, eggs, and lean red meat are a good place to start. Taking an iron supplement is also beneficial. While normal prenatal vitamins may contain iron, experts say it is not enough of the mineral to overcome a deficiency. If someone has anemia, they will likely need a high-dose iron supplement rather than a multivitamin. Since vitamin C aids in iron absorption, some professionals recommend taking vitamin C with iron supplements. However, research supporting vitamin C supplementation in anemia treatment is limited. Small changes in your nutritional regimen can put your baby on a healthier path now and in the future. Generally, be sure to take any needed vitamins and supplements, and eat a nutritious, healthy diet to help you on your way to a smooth pregnancy.