ANEMIA IN PREGNANT WOMEN: EPIDEMIOLOGY, PATHOPHYSIOLOGY, AND APPROACHES TO CLINICAL MANAGEMENT

Abstract

Anemia in pregnant women is one of the most common health concerns in contemporary obstetric practice. It is characterized by a reduction in hemoglobin concentration in the blood and may adversely affect maternal health and fetal development. Iron deficiency is the most common cause of anemia during pregnancy, primarily because of the increased physiological demand for this essential micronutrient. This article examines the epidemiology, underlying pathophysiological mechanisms, clinical manifestations, diagnostic methods, current treatment strategies, and preventive approaches related to anemia in pregnant women. Particular attention is given to the physiological changes in maternal blood composition, including pregnancy-associated hemodilution, which must be distinguished from pathological anemia. The article also discusses the role of iron deficiency, folate and vitamin B12 deficiencies, chronic inflammatory conditions, and inherited hemoglobin disorders in the development of anemia during pregnancy. A comprehensive diagnostic approach is essential for identifying the underlying cause and selecting appropriate treatment. Laboratory assessment generally includes a complete blood count, erythrocyte indices, and serum ferritin measurement, with additional investigations performed when clinically indicated. Management strategies depend on the severity of anemia, the gestational age, the underlying etiology, and the patient's response to treatment. Oral iron supplementation is generally the first-line treatment for confirmed iron-deficiency anemia, whereas intravenous iron may be considered in selected cases when oral treatment is ineffective, poorly tolerated, or insufficient to replenish iron stores. Correction of other nutritional deficiencies and appropriate management of chronic or inherited conditions are also important components of individualized care. Preventive measures include a balanced diet, routine antenatal screening, and iron and folic acid supplementation in accordance with international recommendations and national clinical protocols. Untreated or severe anemia may increase the risk of adverse maternal and perinatal outcomes. Therefore, early identification, accurate diagnosis, appropriate treatment, and continued monitoring are essential for protecting maternal health and supporting normal fetal development. A coordinated approach to the prevention and management of anemia during pregnancy can contribute to improved maternal and neonatal outcomes.