Navigating Iron Infusions During Pregnancy: A Comprehensive Guide

Iron infusions during pregnancy are a significant decision that many expectant mothers face. It's important to be well-informed about your options and the potential implications for you and your baby.

Here’s a comprehensive guide to help you navigate this crucial aspect of pregnancy care.

The Role of Iron in Pregnancy

Iron is essential to help support the developing baby. During pregnancy, your body’s demand for iron increases significantly, especially as you move into the latter part of your pregnancy around 28 weeks.

This is very normal and expected due to the need for more red blood cells to supply oxygen to your growing baby. By the third trimester, iron requirements can be three times higher than in non-pregnant women.

Optimising Iron Levels Preconception

Preconception Care:

If you know you have history of iron deficiency, then it’s an important as part of your pre-conceptive care to optimise your iron levels before you conceive.

Ideally, you’d aim for your ferritin levels (storage form of iron) to sit between 40-50 ug/L
Aim to have your blood tests done at least three months before your planned conception date. When speaking with your doctor, ensure you ask for an Iron Studies and FBC – fasted and done first thing in the morning.
This proactive approach can help prevent iron deficiency anaemia (IDA) during pregnancy. If you have been given a diagnosis of iron deficiency anaemia and you are being recommended an iron infusion, then it’s important to follow this medical advice as this situation does often require the use of IV iron.

The Problem with Iron Infusions

The most common iron infusion available and given routinely in pregnancy is Ferinject (iron carboxymaltose)

While iron infusions can be necessary, in some cases it's important to understand the potential risks involved:

High Hemoglobin Levels: Can increase the risk of perinatal death, low birth weight, and preterm birth.
Anaphylaxis and Hypersensitivity Reactions: All IV iron preparations carry a small but significant risk of severe allergic reactions.
Iron Overload and Oxidative Stress: Potential for excessive iron to cause oxidative damage and increase infection risk.
Hypophosphatemia: Severe low levels of phosphate in the blood can occur.

Lastly ferinject has no safety data on it’s use before 16 weeks gestation.

Where iron deficiency is encountered during pregnancy, oral iron should be the first line of treatment considered before opting for an iron infusion.

How to maintain and optimise iron levels throughout pregnancy to avoid an infusion

When you fall pregnant, it’s important to routinely screen your iron levels to avoid getting into at situation where your levels have plummeted, and an infusion is your only option
I recommend all my pregnant patients are tested for Iron Studies and FBC 6 weeks, 12 weeks, 20 weeks, 26 weeks and 35 weeks. This schedule may alter if I supplement with oral iron so I can monitor and ensure efficacy of treatment
Get in early and begin oral iron if you begin to notice a downward trend in iron levels. It’s important you work with a skilled practitioner who understand the needs of iron in pregnancy and how best to support you through this time. High quality iron supplements, in the form of iron bisglyincate are best

Other Dietary and Lifestyle Strategies to help you absorb the iron

Avoid caffeine, tea, calcium or dairy rich foods 1-2 hours from your iron supplement
Combine iron with vitamin C to optimise absorption
Increase your servings of red meat to 3-4 times a week. Beef gives you 1mg of heme iron per 60g whereas lamb gives you 1mg of iron per 70g. The redder the meat the higher the iron content
Include beef liver alongside your iron supplement to optimise absorption

Iron infusions can be a necessary and effective treatment for iron deficiency anaemia during pregnancy, but they are not without risks. By optimizing your iron levels preconception, regularly monitoring your iron status, and making informed dietary choices, you can support your health and your baby’s development throughout your pregnancy. Always discuss your options with your healthcare provider to ensure the best outcome for you and your baby.

If you want to learn more iron, and how you can support your body naturally in pregnancy without an infusion then you don’t want to miss my upcoming “Iron Masterclass”

Much Love,

Megan