High & Low Haemoglobin Levels During Pregnancy

Researchers believe that about 20% of pregnant women worldwide suffer from anaemia or low haemoglobin levels. Anaemia during pregnancy increases the chances of issues such as maternal and perinatal mortality, premature delivery and a low birth rate.

What Is Haemoglobin?

Haemoglobin is a complex protein in the blood that helps transport oxygen and carbon dioxide to various parts of the body. Iron is the main component of red blood cells, hence the name haemoglobin – ‘haemo’ stands for iron and ‘globulin’ is the name of the protein. The haemoglobin level in women should range between 12 to 16g/dl.

Importance of Haemoglobin During Pregnancy

When a woman is pregnant, she needs more oxygen than normal as the foetus also needs oxygen. Hence, as soon as a woman is pregnant, her haemoglobin level is estimated – the oxygen-carrying capacity of the blood directly depends on the concentration of the circulating haemoglobin.

Normal Range of Haemoglobin

Haemoglobin is measured in g/dl (gram per decilitre). Here is the normal range of haemoglobin in adults.

• When not pregnant: 12 to 15.8 g/dl or 120 to 158 g/L
• 1st trimester of pregnancy: 11.6 to 13.9 g/dl or 116 to 139 g/L
• 2^nd trimester of pregnancy: 9.7 to 14.8 g/dl or 97 to 148 g/L
• 3^rd trimester of pregnancy: 9.5 to 15 g/dl or 95 to 150 g/L

Why Do Haemoglobin Levels Drop During Pregnancy?

Haemoglobin is expected to drop during pregnancy. In fact, it is considered normal for haemoglobin to drop to 10.5g/dl during pregnancy. The reason behind it is quite simple – when a woman is pregnant, her blood volume increases by 50% to provide essential nutrients to the developing baby. By the 8^th week of pregnancy, the level in blood plasma is higher than red blood cells in an expecting mother. Due to a decrease in the concentration of red blood cells in the blood, the haemoglobin level drops down to as low as 10.5g/dl. Anything lower than this needs attention.

Effects of Low Haemoglobin Levels

Haemoglobin levels below 10.5g/dl can have an impact on the health of the pregnant woman. Hence, it is important to take iron supplements during pregnancy as advised by the doctor. Here are a few side-effects of low haemoglobin level during pregnancy:

• You will feel exhausted
• Dizziness will become normal
• Your skin and lips will turn pale
• You will experience shortness of breath even while resting
• You will have increased heartbeat
• Your hands and feet will often be cold
• Your nails will become brittle and break easily

This condition can worsen with a further drop in haemoglobin. If the haemoglobin drops to 6g/dl, then the expecting mother may experience angina. In this condition, a pregnant woman will experience severe pain in the chest which slowly moves to arms, shoulders and neck due to the insufficient flow of blood to the heart.

Are You at Risk of Decreased Haemoglobin?

As mentioned earlier, a slight fall in haemoglobin during pregnancy is normal. But if you enter pregnancy at a stage where your haemoglobin is already below normal, then you may be at a higher risk of decreased haemoglobin during pregnancy. Some of the factors before pregnancy that may contribute to this state of low haemoglobin in a woman are:

• Losing large quantities of blood during periods, especially the last cycle before getting pregnant
• Being on a diet that is low in iron content
• Having donated blood just before pregnancy
• Failing to absorb iron properly
• Getting pregnant soon after your last delivery

There are 3 kinds of haemoglobin issues you might face during pregnancy:

1. Iron-deficiency anaemia – this occurs when the body does not have enough iron to produce optimum haemoglobin.
2. Folate-deficiency anaemia – The body needs folate to produce more RBCs, which help transport oxygen to the tissues of the body. Not eating enough green leafy veggies can cause folate-related issues with haemoglobin.
3. Vitamin B12 deficiency –  The body also needs enough vitamin B12 to form healthy red blood cells. Having a diet lacking in the vitamin can cause issues that directly affect haemoglobin levels.

How to Increase Haemoglobin When Pregnant

Since we know that haemoglobin levels are most likely to go down during pregnancy, you must consult your doctor and take iron supplements. Also, a change in your diet may help you to replenish iron, folic acid, vitamin B12, and vitamin C, without which you could end up with a haemoglobin deficiency.

Here is a list of food items that can help you to fill the gap.

• You must include leafy vegetables like palak, methi, dry fruits, food grains like barley, maize millet, and sesame seeds in your diet. These are reliable sources of iron.

• Fruits rich in iron, such as guava, kiwi, peaches, figs, apples, etc. are a must-have in your everyday diet.

• Food rich in vitamin C must be included in your diet as it helps the body absorb iron. Fruits like kiwi, orange, lime and raspberries are excellent sources of vitamin C. Dark leafy greens, bell peppers, broccoli and tomatoes are also rich in Vitamin C and must be included in your diet.

• Folic acid and vitamin B complex help in the production of red blood cells which, in turn, boost the level of haemoglobin the body. Therefore, food items rich in folic acid and vitamin B complex like avocado, okra, lettuce, turnip, sprouts, etc. should also be a part of your daily meals.

• It has been observed that excess intake of calcium, gluten, and caffeine can block the absorption of iron by the body. Hence, during pregnancy, one must limit the intake of:

1. Coffee/tea
2. Alcohol
3. Pasta and wheat products (gluten)
4. Parsley (oxalic acid)
5. Milk products

When Do Haemoglobin Levels Become High During Gestation?

Haemoglobin levels during pregnancy may arise due to conditions related to the heart, lungs, and kidneys. Haemoglobin in a pregnant woman may also rise due to:

1. Dehydration

If there is a decrease in fluid or water intake during pregnancy, you may experience a sudden rise in haemoglobin. The same comes under control the moment your fluid intake increases.

2. Erythrocytosis

In this condition, a sudden rise is seen in red blood cells. During pregnancy, if, for some reason, the body fails to meet the oxygen demand of various tissues, there is an increase in the production of red blood cells. This obviously increases the haemoglobin levels in the body.

3. An Overdose of Iron Supplements

A rise in the iron level in the body results in a sudden increase in haemoglobin levels. Hence, do not take iron supplements without consulting your doctor.

Effects of High Haemoglobin Levels

You may be surprised, but high haemoglobin levels during pregnancy can be quite dangerous. Here are some unwanted outcomes of high haemoglobin during pregnancy:

• It increases the chances of low birth weight or LBW
• During the 1^st and 2^nd trimester, it can result in foetal SGA (small for gestational age)
• If the haemoglobin level goes above 14g/dl during 2^nd trimester, it may indicate preeclampsia
• Increase in the thickness of blood can directly affect the flow of blood in the body of the mother. As a result, the blood may not reach the placenta, and that will obviously hamper the healthy development of the baby.

Treating High Haemoglobin Levels

There is no prescribed home remedy for high levels of haemoglobin during pregnancy. This must be treated by an expert as and when they deem fit. You will be monitored closely by a specialist who will decide the treatment pattern based on your symptoms.

To enjoy your pregnancy to the fullest, keep a watch on what you eat, listen to your body and especially to your doctor. In case of the slightest doubt, consult your doctor immediately.

Resources and References: WebMD