Anemia In Pregnancy


According to various Government institutes, it is the most common disease in pregnancy, affecting approximately 60-70% of pregnant mothers in India. Most of them suffer from anemia preconception either due to nutritional deficiency or due to heavy blood loss in menstruation. Their symptoms are unmasked due to increased requirements in pregnancy.

Hemodilution Of Pregnancy:

During pregnancy the metabolic requirement of growing fetus and host mother is very high. The baby is entirely dependent on mother for both, its nutritional requirements and excretion of wastes.

To facilitate increased blood supply to the baby, there is increased demand on mother’s heart and circulatory system. The maternal blood volume increase from 5 liters to 6.5 liters. However, this rise is not synchronized amongst various blood components.

The volume of liquid plasma rises by 40-50%, as against 30-40% increase in Red blood cells, resulting in lower viscosity of blood to facilitate easy blood flow. This adaptive phenomenon is called as Hemodilution of Pregnancy.

But, if the hemoglobin drops below 10gm% then it is considered as Anemia and requires intervention.

Anemia In Pregnancy:


According to World Health Organization, the anemia in pregnancy is defined as the concentration of hemoglobin less than 10 gm%, RBC count less than 3.2 million/ Or Pack cell volume less than 30%.

Around 2/3rd pregnant mothers in underdeveloped and developing world suffer from Anemia in Pregnancy.

Classification of Anemia in Pregnancy!


8-10 gm%


6.5-8 gm%


<6.5 gm%

Symptoms of Pathological Anemia:


Classification of Anemia according to Cause:

  • Nutritional anemia-

Hemoglobin synthesis requires Globin protein, Iron, Vitamin B12, Folic acid, Vitamin C, Erythropoietin hormone produced from kidneys along with minerals. Deficiency of any of these raw materials in our diet may result in nutritional anemia.

The most common cause of anemia is deficiency of Iron, Vitamin B12 and Folic acid affecting around 50-70% females.

  • Abnormal Hematopoiesis (Production of Blood )
  • Hereditary chromosomal and genetic diseases like Thallesemia and Sickle cell disease may result in abnormal production of hemoglobin resulting in familial anemia.
  • Blood cancers, viral infections like parvovirus B19, chemotherapy etc. may adversely affect the bone marrow resulting in abnormal production of blood components called Aplastic Anemia.
  • Hemorrhage:
  • The second most common cause of anemia in females is untreated heavy menstrual bleeding.
  • Bleeding from digestive tract (Oral, Gastric, Intestinal Ulcers), worm infestations, piles etc.
  • Hemolysis (Blood cells destruction):
  • Hereditary chromosomal and genetic disorders leading to production of red blood cells with abnormal size, shape and quality may result in destruction. Eg. Hereditary spherocytosis, Thallesemia, Sickle cell disease etc.
  • Malaria or Viral infections.
  • Swelling of liver or spleen.
  • Other causes:
  • Chronic diseases such as Tuberculosis, Chronic kidney disease, Liver failure etc.

Side effects of Anemia on Mother:

  • Preterm labor
  • Pregnancy induced hypertension.
  • Frequent infections.
  • Shock
  • Separation of placenta from its bed (Abruptio Placeta).
  • Heart failure.

Side effects of Anemia on Fetus:


  • Intrauterine growth retardation.
  • Premature birth.
  • Sudden intrauterine fetal death.
  • Neonatal anemia.

Some suggestions to prevent Anemia in Pregnancy!


  • Promote healthy diet and life style in adolescence and pre-pregnancy.
  • Prevent worm infestations and infections.
  • Preconception counseling.
  • Preconception folic acid intake, at least for 3 months.
  • Address abnormal uterine bleeding and heavy menstruation.
  • Genetic counseling and screening to prevent hereditary disorders.
  • Take iron tablets and injectables during pregnancy under supervision of Doctor.


The information is shared to create awareness towards Pregnancy and Childcare to reduce maternal and child deaths. Atmost care has been taken by the author to include the verified information from authentic sources. However, kindly discuss the same with your health care provider before implementation.