Effect of Iron and Folic Acid Deficiency during Pregnancy on Maternal and Neonatal Hemoglobin Concentration

Abstract

Background: The nutritional status of iron and folic acid deficiency in pregnancy is common and can be associated with maternal anemia and poor neonatal hematological status. Mother's haemoglobin is vital to carry oxygen to the unborn and to the newborn baby and play an important role in fetal growth and baby's wellbeing.

Objective: To determine the frequency of maternal iron and folic acid deficiency during pregnancy and to assess its relationship with maternal and neonatal haemoglobin concentration.

Methods: A descriptive cross-sectional study was done at Pak International Medical College Peshawar from January 2025 to June 2025. The total pregnant women were collected by non-probability consecutive sampling technique of 75 women. A structured proforma was used to gather maternal demographic, obstetric, antenatal and supplementation information. Haemoglobin, serum ferritin, serum iron and serum folate levels were measured. After birth, the level of haemoglobin in the blood of the baby was measured and the effects of birth were noted. The SPSS software was used for data analysis. All categorical variables were given frequencies and percentages, and all quantitative variables were calculated using mean and standard deviation. Data were analyzed using independent sample t-test, chi-square test and Pearson correlation, as appropriate. A p-value value of < 0.05 was regarded as significant.

Results: The mean maternal haemoglobin concentration was 10.1 ± 1.4 g/dL, and maternal anemia was observed in 49 (65.3%) women. Iron deficiency was present in 42 (56.0%), folic acid deficiency in 31 (41.3%), and combined iron and folic acid deficiency in 24 (32.0%) women. Women with iron deficiency had significantly lower maternal haemoglobin levels than non-deficient women (9.4 ± 1.1 g/dL vs. 11.0 ± 1.2 g/dL, p < 0.001). Folic acid deficiency was also significantly associated with lower maternal haemoglobin concentration (p = 0.002). The mean neonatal haemoglobin concentration was 14.7 ± 1.6 g/dL. Neonates born to iron-deficient and folic acid-deficient mothers had significantly lower haemoglobin levels. A moderate positive correlation was observed between maternal and neonatal haemoglobin concentration (r = 0.58, p < 0.001).

Conclusion: Maternal iron and folic acid deficiency were common during pregnancy and were significantly associated with reduced maternal and neonatal haemoglobin concentration. Regular antenatal screening, dietary counseling, and improved compliance with iron and folic acid supplementation are recommended to improve maternal and neonatal hematological outcomes.