By Deborah Kolawole; Sydani Institute for Research and Innovation 

As the world prepares to mark World Anaemia Day, we must reflect and take action to reduce the devastating consequences of anaemia in pregnancy, particularly during a season often associated with love and care. Although anaemia is a preventable condition with proven interventions, it continues to compromise child survival, growth, and development. Globally, it affects 32 million individuals (1), especially individuals in low-and middle-income settings, like sub-Saharan African countries, where 50% of pregnant women experience anaemia regardless of their residence location (2). In Nigeria, anaemia affects 58% of pregnant women (3). All these figures emphasize the urgent need to look into sustainable actions to reduce anaemia in pregnancy, while protecting children’s future. 

Definition and Causes 

Anaemia in pregnancy is a condition characterized by a lower haemoglobin level than the normal cut-off of 11g/dl (4,5). The primary causes of anaemia in pregnancy are iron deficiency, increased blood volume (which reduces the red blood cell mass), vitamin B9 deficiency, vitamin B12 deficiency, chronic infections such as malaria, tuberculosis, HIV, and hookworm infestation. Furthermore, some factors that may put a pregnant woman at risk of developing anaemia are insufficient consumption of iron-rich foods, having pregnancies in close succession, carrying a twin pregnancy, heavy periods before pregnancy, and severe morning sickness.  

Symptoms and Consequences 

Anaemia in pregnancy can cause a wide range of non-specific symptoms, such as fatigue, tiredness, dizziness/light-headedness, headache, cold limbs, and breathlessness on exertion. Severe anaemia may cause other symptoms, including pale skin, rapid breathing and heart rate, easy bruising, and pale mucous membranes. Beyond causing maternal complications such as anaemic heart failures, post-birth bleeding, and increased risk of maternal death, anaemia causes unpleasant short- and long-term birth outcomes in foetus and neonate, such as intrauterine growth restriction, stillbirths, birth asphyxia, low iron stores at birth,  low birth weights, impaired cognitive and motor development, and decreased immunity, which contributes to future childhood anaemia.. These outcomes occur because reduced maternal haemoglobin limits the supply of oxygen and nutrients to the foetus, thereby impeding physical growth and development. Notably, new evidence indicates that anaemia within the first 100 days of pregnancy increases the risk of developing congenital heart disease in children. Together, these effects show how anaemia in pregnancy directly links maternal health to child health outcomes, emphasizing the need for early detection and timely intervention. 

Prevention Strategies 

The solemn impact of anaemia during pregnancy emphasizes the need to prioritize prevention and control through integrated, evidence-based interventions provided during antenatal care. Iron and folic acid supplementation is essential to prevent anaemia because it supports haemoglobin production, reducing adverse maternal and child outcomes. However, supplementation is not enough; it must be paired with balanced nutrition and proper dietary counselling. For example, heme-iron and non-heme foods such as liver, meat, green vegetables like spinach, beans, fortified cereals, and lentils should be paired with vitamin C sources to improve iron absorption.  Anaemia in pregnancy can be worsened by malaria and intestinal parasites; therefore, preventive measures such as malaria prophylaxis, deworming, and improved hygiene are crucial in preventing iron deficiency. In addition, early registration for antenatal care and consistent antenatal visits, as recommended by the WHO (minimum of 8 visits) [6], are important to implement these interventions, as they facilitate early screening, regular follow-up, and health education, thereby reducing the burden of anaemia in pregnancy. 

Implementation Challenges 

Anaemia in pregnancy continues to be a challenge despite the availability of effective interventions due to significant gaps in implementation across various settings. For instance, opportunities for early screening, supplementation, and counselling are limited by the late commencement of antenatal care. Even when iron and folic acid supplements are provided, poor adherence, misinformation, and inconsistent use weaken their effectiveness. These challenges are exacerbated by weak health systems, frequent stockouts of essential medicines, limited health worker capacity, and supply chain disruptions. In many settings, cultural norms, household power dynamics, and financial hardship limit women’s access to timely and sustained care. These barriers highlight that anaemia in pregnancy is not a failure of evidence, but a failure of delivery. 

Pathways to action 

The process of reiterating evidence into effective action involves improving existing approaches and proactively responding to new evidence. The World Health Organisation (WHO) recommends oral iron supplementation as a foundation for preventing maternal anaemia. New evidence suggests that other approaches are also necessary for women who remain anaemic despite existing approaches. A clinical trial among pregnant women in Malawi showed that administering intravenous iron in the third trimester of pregnancy can significantly reduce anaemia prevalence and protect iron and potassium stores at delivery compared with oral iron therapy alone (6). These observations emphasize the urgent need to develop antenatal care approaches that are responsive to the specific needs of women, particularly in the context of moderate to severe anaemia. The effective management of anaemia in pregnancy requires a collective effort on multiple levels: strong policy engagement, improvements in health system performance, and vigorous community mobilization. The future of our children begins with healthy mothers during pregnancy, by applying not only effective approaches but also ensuring that they are accessible, acceptable, and implemented with maximum effectiveness.  

On World Anaemia Day, the message is clear: caring for mothers during pregnancy is an act of love that shapes children’s lives long after birth. 

REFERENCES 

1. Shah T, Khaskheli MS, Ansari S, Lakhan H, Shaikh F, Zardari AA, et al. GestationalAnemiaand its effects on neonatal outcome, in the population of Hyderabad, Sindh, Pakistan. Saudi J Biol Sci. 2022 Jan;29(1):83–7.  
2. Nyarko SH, Boateng ENK, Dickson KS,AdzragoD, Addo IY, Acquah E, et al. Geospatial disparities and predictors of anaemia among pregnant women in Sub-Saharan Africa. BMC Pregnancy Childbirth. 2023 Oct 20;23(1):743.  
3. Babah OA,AkinajoOR, Beňová L, Hanson C, Abioye AI, Adaramoye VO, et al. Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study. BMC Pregnancy Childbirth. 2024 Jan 5;24(1):39.  
4. WHO. https://www.who.int/news-room/fact-sheets/detail/anaemia. 2026 [cited 2026 Feb 3]. Anaemia. Available from: https://www.who.int/news-room/fact-sheets/detail/anaemia
5. World Health Organization, editor. Guideline on haemoglobin cutoffs to define anaemia in individuals and populations. Geneva: World Health Organization; 2024. 1 p.
6. Walter and Eliza Hall Institute. Healthier mothers, healthier babies: Iron infusion trial could transform pregnancy care worldwide | ScienceDaily [Internet]. 2025 [cited 2026 Feb 3]. Available from: https://www.sciencedaily.com/releases/2025/01/250106132325.htm