North American Registry of Midwives (NARM) Practice Exam

What is the primary cause of true anemia in pregnant women?

1. Vitamin B12 deficiency

2. Folic acid deficiency

3. Iron deficiency

4. Chronic disease

The correct answer is: Iron deficiency

The primary cause of true anemia in pregnant women is iron deficiency. During pregnancy, the body undergoes significant changes, including an increased demand for iron to support the growing fetus and to expand the maternal blood volume. The requirements for iron are heightened due to the needs of the developing baby and the increase in red blood cells that occurs to meet these needs. Iron is crucial for the production of hemoglobin, the protein in red blood cells that carries oxygen. A deficiency in iron can lead to a decrease in hemoglobin levels, resulting in iron-deficiency anemia, which is characterized by a low red blood cell count and reduced oxygen delivery to tissues. Pregnant women are particularly vulnerable to iron deficiency due to dietary inadequacies, increased blood volume, and the demands of fetal development. While vitamin B12 deficiency and folic acid deficiency are also important in the context of anemia, they primarily contribute to megaloblastic anemia, which is different from the true anemia caused by inadequate iron levels. Chronic diseases can also lead to anemia, but the majority of anemia cases in pregnancy are attributed to iron deficiency. Therefore, understanding the role of iron in pregnancy is key to preventing and managing true anemia in this population.