Anaemia in Pregnancy

Anaemia in pregnancy is a lower-than-normal level of haemoglobin during pregnancy, most commonly due to iron deficiency, and is very common in Tanzania. It increases the risk of complications for both mother and baby if left untreated.

• Fatigue and weakness, which can be more pronounced than typical pregnancy tiredness
• Pale skin, lips, and inner eyelids
• Shortness of breath on exertion
• Dizziness or palpitations
• Severe anaemia can cause breathlessness at rest and, in advanced cases, signs of heart strain

• Increased iron requirements during pregnancy to support the growing baby and increased maternal blood volume, often not met by diet alone.
• Underlying iron deficiency prior to pregnancy.
• Malaria in pregnancy, which can worsen anaemia, particularly in endemic areas.
• Hookworm infestation and other causes of chronic blood loss.
• Closely spaced pregnancies, which reduce the time available to rebuild iron stores between pregnancies.

• Screened for routinely at antenatal visits using a haemoglobin test.
• Severity is classified as mild, moderate, or severe based on the haemoglobin level, which guides management and the urgency of referral.
• Assessment for contributing causes, such as malaria testing and, where relevant, stool examination for hookworm, supports management.

Routine iron and folic acid supplementation is given to all pregnant women throughout pregnancy as part of standard antenatal care, both to prevent and to help correct mild anaemia.

Confirmed anaemia is treated with a therapeutic dose of oral iron supplementation, continued for an adequate duration to correct the deficiency and rebuild iron stores.

Any contributing cause identified, such as malaria or hookworm infestation, is treated according to the relevant protocol.

Severe anaemia, especially with signs of heart strain, breathlessness at rest, or near term, is managed urgently at hospital level and may require blood transfusion, particularly if delivery is approaching or complications arise.

• Attend all scheduled antenatal visits, where haemoglobin is checked routinely.
• Take iron and folic acid supplements as prescribed throughout pregnancy.
• Sleep under an insecticide-treated mosquito net and take intermittent preventive treatment for malaria in pregnancy as recommended.
• Eat iron-rich foods where available as part of a balanced diet during pregnancy.