Anaemia during pregnancy remains a major public health challenge across Nigeria, contributing significantly to maternal morbidity and perinatal mortality. World Health Organization guidelines define anaemia in pregnant women as a haemoglobin concentration below 11.0 g/dL. However, the Nigerian Federal Ministry of Health often highlights a regional threshold of less than 10.0 g/dL for severe local context, though clinical practice standardly adopts the 11.0 g/dL cutoff for early intervention. This condition impairs oxygen delivery to maternal tissues and the developing fetus, sparking a cascade of obstetric complications if left unmanaged.
During gestation, maternal blood volume expands dramatically by roughly 40 to 50 percent to meet the metabolic demands of the uteroplacental unit and prepare for anticipated blood loss during delivery. Plasma volume increases much more than red blood cell mass, creating a relative dilution known as physiological haemodilution or pseudoanaemia. This mismatch causes a normal drop in haemoglobin and haematocrit levels, especially during the second trimester. Midwives and nurses must recognize this process to avoid misinterpreting normal pregnancy adaptation as true pathological deficiency.
Mild anaemia can remain entirely silent, but as haemoglobin levels fall, women present with classic signs of tissue hypoxia.
Accurate diagnosis requires laboratory confirmation beyond clinical appearance. A baseline complete blood count measures haemoglobin and haematocrit levels. Further evaluation often includes red cell indices such as mean corpuscular volume to classify the type of anaemia. Serum ferritin testing offers the most accurate assessment of stored iron levels, though acute-phase inflammation can falsely elevate it. In malaria-endemic regions, routine screening via blood film microscopy or rapid diagnostic tests is standard practice during antenatal booking.
Uncorrected anaemia carries grave risks for both mother and baby. For the mother, reduced oxygen reserves lower tolerance to postpartum hemorrhage, increasing the likelihood of shock and maternal death. It also raises vulnerability to puerperal sepsis due to compromised immune function. Fetal impacts include intrauterine growth restriction, low birth weight, preterm birth, and diminished Apgar scores at delivery.
Management strategies focus on correcting deficiencies and treating underlying triggers. Routine prophylaxis involves daily oral supplementation with ferrous salts and folic acid for all pregnant women attending antenatal clinics. Therapeutic doses are prescribed when confirmed anaemia is diagnosed. Intravenous iron preparations may be utilized if oral iron is poorly tolerated or if severe anaemia presents late in pregnancy. Intermittent preventive treatment for malaria and insecticide-treated bed nets remain core preventative measures in endemic zones.
Nurses play a frontline role in mitigating anaemia through targeted health education and continuous monitoring. Care plans include assessing dietary habits to encourage the intake of local iron-rich foods like dark green vegetables, beans, and lean meats, while discouraging substances like tea or coffee that inhibit iron absorption. Nurses counsel clients on taking iron supplements with vitamin C sources, such as orange juice, to enhance uptake. Furthermore, educating women on recognizing warning signs and complying with scheduled malaria prevention strategies ensures holistic protection.