Maternal Anemia

This chapter provides an algorithm for the initial evaluation of anemia in pregnancy, with treatment algorithms for the most common causes in pregnancy. In developed countries, maternal anemia has been associated with increased risk of preterm birth and low‐birthweight infants, as well as neonatal and perinatal death. Mixed nutritional deficiencies (folate and iron) may lead to normocytic anemia in pregnancy, but routine supplementation makes the probability of such a scenario low. Most cases of microcytic anemia in pregnancy are due to iron deficiency anemia. In a typical singleton gestation, maternal iron requirements (including blood volume expansion as well as fetal and placental requirements) average 1g for the entire pregnancy, with this requirement further increased in the setting of multiple gestations. Compared to routine supplementation in pregnancy, higher doses of iron are required for the treatment of maternal anemia. Oral iron therapy is most often utilized for the treatment of maternal anemia.