Prognosis

The prognosis of iron deficiency is directly related to the cause. If it is possible to cure the causative disease, it is likely that the iron deficiency can be corrected.

Iron deficiency during pregnancy

For sufficient blood circulation and development of the child, the woman must produce about 30-40% more blood during pregnancy. Since for the blood formation i. Since iron is needed for blood formation, the iron requirement during pregnancy increases significantly, approximately twice as much, so that there is an increased risk of iron deficiency.

Women with a multiple pregnancy or pregnancies in quick succession are particularly at risk, but low body weight and unbalanced nutrition are also risk factors. Anemia, which may be caused by iron deficiency, is a risk factor for both mother and child during pregnancy in addition to the usual symptoms. On the one hand, the baby may be endangered by a poorer oxygen supply, and on the other hand, the placenta may not develop completely.

If it is too small, a sufficient supply of important nutrients to the baby is no longer necessarily guaranteed. Ultimately, growth disorders or even intrauterine infant death (i.e. within the uterus, even before birth) can be the result. In addition, there are certain risks for the development of the child after birth, e.g.B.

motor developmental disorders, mental retardation or behavioural problems. The mother is generally less physically resilient and has reduced blood reserves at birth, which increases the risk of necessary blood transfusions. Other possible consequences are pre-eclampsia (a clinical picture with, among other things, high blood pressure and protein loss via the urine) or inflammation of the renal pelvis.

All these circumstances can lead to more frequent and/or longer hospital stays. However, iron deficiency alone, without the accompanying anemia, can also be responsible for various complications. These include premature labor, premature birth and low birth weight.

Since the organism prefers to allocate the available iron to the baby during pregnancy, the deficiency exists in the mother’s body long before it manifests itself in the child. The German Society for Nutrition (DGE) therefore recommends a daily iron intake of 30 mg for pregnant women and 20 mg for nursing mothers (in contrast: non-pregnant adults approx. 10-15 mg).

During pregnancy (especially from the second trimester onwards) it is therefore particularly important to ensure a sufficient intake of iron-containing foods, preferably in combination with vitamin C (e.g. a glass of orange juice), as this improves absorption in the body. However, the simultaneous intake of substances that inhibit iron absorption should be avoided; these include calcium preparations, antacids (stomach acid binding agents) and certain antibiotics (tetracyclines). In routine controls during pregnancy, the blood is also checked for iron deficiency (including ferritin) and anemia (including hemoglobin).

Abnormal values should always be clarified with regard to the causes. A hemoglobin value below 10 mg/dl is generally considered to be a risk pregnancy. If an iron deficiency persists even with a balanced diet, additional iron tablets can be taken.

However, this therapy must be maintained for several months and can lead to various side effects, especially gastrointestinal complaints. Some pregnant women already take such iron preparations as a precautionary measure without existing conspicuous blood values, but this does not have to be recommended in principle. Alternatively, an intravenous administration can be considered (especially if the hemoglobin value is below 9 mg/dl), whereby very high doses can be administered in a short time without hitting the stomach and intestines simultaneously. The procedure for iron deficiency in pregnancy should always be discussed individually with the treating physician; there are no general therapy recommendations in Germany.