Anaemia in Pregnant African Women: Causes and Symptoms


By: Ruth Abi, B. Pharm. Freelance Health Writer and Datelinehealth Africa Volunteer. Medical review and editorial support provided by the Datelinehealth Africa Team

Pregnant African women seated at an antenatal clinic

Pregnant African women seated at an antenatal clinic. Credit



  • Anaemia is a very common public health problem in pregnant African women, but it is preventable.
  • The common causes are nutritional deficiencies, infections, heavy blood loss prior to pregnancy and heredity (Sickle Cell Disease).
  • Contributory factors include; having multiple babies at once, poorly spaced pregnancies, poor diet, heavy menstrual bleeding prior to pregnancy, excessive vomiting from morning sickness, infections (malaria and hookworm), etc.
  • Common symptoms are the same as in anaemia generally, and include tiredness, dizziness, pale appearance, headache, shortness of breath, decreased stamina, sore mouth and tongue, etc.
  • Consequences to the mother and unborn baby can be grave when left untreated or inadequately treated.
  • Access to cheap but standard antenatal care will reduce the impact of this condition and improve the health of  pregnant women and their unborn babies across Africa.  




Have you ever noticed that many pregnant African women take two familiar medications? A tiny yellow tablet and a reddish-brown one. Perhaps you’ve wondered what these medications are and why they are so crucial for expectant mothers.


In this article, we will learn about anaemia in pregnant African women, a condition where these two lifesaving drugs are needed.


What is anaemia?

Anaemia is a condition where the number of red blood cells or the concentration of haemoglobin within them is lower than normal. [1] Haemoglobin helps to carry oxygen to organs and tissues. When there is anaemia, there isn’t enough haemoglobin to carry out that function, hence, the body suffers. [2]


How common is anaemia in pregnant African women?

Anaemia in pregnancy is a public health concern in sub-Saharan Africa. The prevalence rate varies between countries and even between different geographic areas (i.e., rural versus urban) of a country. Although it is estimated that 41.8% of pregnant women worldwide are anaemic, in Africa, the rate is much higher at 57.1%. [3]


Common causes of anaemia in pregnant African women


1. Nutritional deficiencies


An important cause of anaemia during pregnancy is nutritional deficiencies. What this means is that the pregnant woman is not getting an adequate amount of the nutrients her body needs. These nutrients could be iron, folate or vitamin B12. Pregnant women are more at risk for nutritional deficiencies because their body also caters to the needs of the unborn baby. 

Here are some common nutritional deficiencies that cause anaemia generally, as well as in pregnant women:


  • Iron deficiency

A person is said to be iron deficient when the amount of iron in the body is lower than normal. We get iron from the food we eat and the nutrient supplement that we take. If your diet does not contain the necessary amount of iron, it leads to iron deficiency. Iron is an important mineral because it helps in the production of red blood cells. In the red blood cells, iron forms a component of haemoglobin specifically. Thus, very little iron means insufficient haemoglobin, causing anaemia. Iron deficiency is considered to be the main cause for anaemia in pregnancy. [4]


  • Folate deficiency

A lower amount of folic acid in the blood than normal is called folate deficiency. Just like iron, folic acid is also gotten from diet or supplements. Folic acid is a B vitamin that helps in the production of red blood cells. When folic acid is deficient, it affects the production of red blood cells and causes anaemia. [5]


  • Vitamin B12 deficiency

When the body lacks an adequate amount of vitamin B12, it is called vitamin B12 deficiency. Vitamin B12 helps in the production of red blood cells. A deficiency in vitamin B12 leads to a deficiency in healthy red blood cells, and subsequently, anaemia. [6]

2. Infections


  • Malaria

In Africa, malaria is one of the most common diseases of public health concern. It is spread by the bite of an infected female Anopheles mosquito. After the bite of an infected mosquito, the malaria parasite gets into the blood and infects the red blood cells. Eventually, the infected red blood cells burst. This reduces the amount of red blood cells in the body, and leads to severe anaemia and a high risk of pre-term delivery and stillbirths. [7]


  • Hookworm infestation

Hookworms are parasites that are transmitted to humans from the soil. They live off the resources humans produce by latching to the intestine and sucking blood. If this blood loss cannot be compensated for, especially in people with nutritional deficiencies, it causes a deficiency in iron, which leads to anaemia.


Hookworm infection in pregnant women may have adverse effects on both the mother and the unborn baby. Effects on the unborn baby include delayed growth, as well as physical and mental impairment. Effects on the mother may include anaemia, which, if severe may lead to death. [8]

3. Genetics


  • Sickle cell anaemia

Sickle Cell Anaemia (SCA) gets its name from one of the major symptoms that patients with Sickle Cell Disease (SCD) experience, which, is anaemia. SCD is an inherited blood disorder that is marked by imperfect haemoglobin, the protein in red blood cells that carry oxygen to tissues of the body. 


Whereas red blood cells with normal haemoglobin, are smooth, round shaped and move freely in blood vessels, the red blood cells in sickle cell disease are stiff and sticky. They appear sickle or crescent shaped when they loose their oxygen.

Due to their shape and stickiness, the red blood cells in SCD block blood vessels to cause pain especially in the bones. They are also readily destroyed compared to normal ones. It is this destruction that causes the anaemia associated with sickle cell disease.

So, a pregnant woman with SCD is more likely to experience anaemia compared with their healthy counterparts. This is because unhealthy red blood cells live for a short time (12 - 20 days), while normal red cells can live up to 120 days. This puts pregnant women with SCD in a situation where they are constantly short of red blood cells (i.e., have anaemia).


SCA in pregnancy puts both pregnant women and their unborn babies at high risk of poor outcomes. The effect on pregnant women may include preeclampsia, eclampsia, and acute pulmonary (chest) failure. Effects on the unborn baby may include higher risks of spontaneous abortions and stillbirths. [9]


Pregnant women with SCA face higher death and disability rate, but more recent advances in the treatment have improved outcomes globally. In sub-Saharan Africa though, the impact of these treatments remain limited.


4. Acute blood loss


  • Heavy menstrual bleeding (before pregnancy)

Heavy menstrual bleeding is also known as menorrhagia. It is characterized by bleeding that lasts longer than 7 days, having to change pads after every 2 hours or less, wearing more than one pad per time, having to change pads during the night, large blood clots, disruption of normal activities, tiredness, shortness of breath and lack of energy.


Heavy menstrual bleeding can make iron levels low, reduce the amount of haemoglobin and cause anaemia even before pregnancy occurs. Such a situation worsens the risk of severe anaemia occurring during pregnancy. [10]


What puts pregnant African women at risk of anaemia?


The following are common conditions that increase the risk of anaemia in African pregnant women: [10, 11]

  • Multiple babies at once
  • Two pregnancies close to each other
  • Poor diet
  • Excessive vomiting due to morning sickness
  • Heavy menstrual bleeding before pregnancy
  • Intestinal parasites
  • Sickle cell anaemia
  • Malaria


Symptoms of anaemia in pregnancy


Anaemia including during pregnancy can cause the following symptoms: [11]

  • Tiredness
  • Shortness of breath
  • Heart palpitation
  • Dizziness
  • Paleness
  • Brittle nails
  • Headache
  • Decreased stamina
  • Swollen/sore tongue
  • Mouth sores


Diagnosis and Treatment    





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Published: June 20, 2024

Updated: June 29, 2024

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