Obstetric Outcome in Pregnancies Complicated by Recurrent Anaemia, With Observations on Iron and Folate Metabolism, Bacteriuria and Pre‐eclampsia

Summary: Three hundred and thirty‐one pregnant women were studied to see whether moderate maternal anaemia or iron and folate deficiency in the absence of anaemia had any adverse effect on the fetus. When results from all subjects were analysed, no correlations between haematological findings and measures of fetal well‐being were apparent, except for a tendency for increased placental weight when the haemoglobin (Hb) concentration was low at the end of pregnancy. However, haematological and obstetrical complications appeared to be related in 2 sub‐groups, (i) those with a history of anaemia in previous pregnancies, and (ii) those with significant bacteriuria. Patients who were anaemic in previous pregnancies tended to have persistent hypochromic anaemia in the study pregnancy; their low Hb and red cell hypochromia were associated with a history of past abortions and low birth weight in the present pregnancy. These complications were ascribed to anaemia at the time of conception and in early pregnancy. Patients with significant bacteriuria were shorter and had lower Hb on average, and the degree of red cell abnormality correlated with premature delivery and low birth weight. Both obstetric and haematological complications were likely to have been direct consequences of underlying renal tract disease, and blood film reports could be of value in assessing pregnancies complicated by bacteriuria. There was no evidence that pre‐eclampsia or hypertension from other causes was associated with anaemia, but the Hb was significantly higher in this subgroup. There was a tendency to hypersegmentation of the neutrophil polymorphs, but serum and red cell folate levels did not suggest that this was the result of folate deficiency.