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Anemia is one of the most commonly encountered medical disorders during pregnancy .

AccordingtoWHO,

hemoglobinlevelbelow11gm/dlinpregnantwomenconstitutesanemiaandhemoglobinbelow7gm/dl
issevereanemia.TheCenterforDiseaseControlandPreventiondefinesanemiaaslessthan11gm/dl
inthefirstandthirdtrimesterandlessthan10.5gm/dlinsecondtrimester.

EFFECTS OF ANAEMIA ON PREGNANCY


Maternal effects
Mild, anemia may not have any effect on pregnancy and labour except that the mother will have low iron stores
and may become moderatelyto- severely anemic in subsequent pregnancies. Moderate anemia may cause increased
weakness, lack of energy, fatigue and poor work performance. Severe anemia, however, is associated with poor
outcome. The woman may have palpitations, tachycardia, breathlessness, increased cardiac output leading on to
cardiac stress, which can cause de-compensation and cardiac failure which may be fatal 5,8. Increased incidence of
pre-term labour (28.2%), pre-eclampsia (31.2%) and sepsis have been associated with anemia. 5

Fetal effects8
Irrespective of maternal iron stores, the fetus still obtains iron from maternal transferrin, which is trapped in the
placenta and which, in turn, removes, and actively transports iron to the fetus. Gradually, however, such fetuses
tend to have decreased iron stores due to depletion of maternal stores. Adverse perinatal outcome in the form of
pre-term and small-for-gestational-age babies and increased perinatal mortality rates have been observed in the
neonates of anemic mothers. Iron supplementation to the mother during pregnancy improves perinatal outcome.
Mean weight, Apgar score and haemoglobin level 3 months after birth were significantly greater in babies of the
supplemented group than the placebo group.

Corticosteroids administered during pregnancy or maternal Cushings syndrome can


cause suppression of fetal adrenal glands (1,2,3,4,5,6,7). Maternal use of
corticosteroids is needed in case of fetal congenital adrenal hyperplasia, as well as in
maternal diseases such as idiopathic thrombocytopenic purpura (ITP), Crohns
disease, systemic lupus erythematosus, Addisons disease and rheumatological
problems (3,8,9). Short-term corticosteroid treatment is given in case of preterm labor
to enhance fetal lung maturation (8). When using corticosteroids during pregnancy,
the choice of preparation type and dose is of utmost importance - steroids crossing the
placenta freely should be given if the target is fetus, while those passing across the
placenta should be used in smaller amount if maternal disorders are being treated

Corticosteroids are given during pregnancy if needed in maternal diseases or other


pregnancy-related problems as well as to treat certain fetal diseases; in the latter cases,
corticosteroids capable of crossing the placenta are administered to the mother
(5,6,7,8,9).
As side effects to the mother, steroids used during pregnancy can cause weight gain,
dyslipidemia, hypertension, cushingoid appearance, acne, hypertrichosis,
psychological problems

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