Anemia in pregnancy is a common concern, and it can have significant implications for both the mother and the developing fetus. However, it is sometimes underdiagnosed for several reasons.
Mild to moderate anemia in pregnancy may be asymptomatic or present with vague symptoms that can be overlooked. Fatigue, weakness, and shortness of breath are common symptoms of anemia, but these can also be attributed to the normal changes and demands of pregnancy.As a result, healthcare providers may not always associate these symptoms with anemia.

Many of the physiological changes that occur during pregnancy, such as an increase in blood volume, can lead to dilution of red blood cells, making it appear as if the hemoglobin levels are lower than they actually are. This can lead to a misconception that mild anemia is a normal part of pregnancy, leading to underdiagnosis.
In some cases, routine screening for anemia during pregnancy may not be consistently performed or may not be prioritized. This can be due to resource constraints, variations in healthcare practices, or lack of awareness among healthcare providers about the prevalence and impact of anemia in pregnancy.

The diagnostic criteria for anemia can vary, and there may be differences in the thresholds used to define anemia in pregnant women. Some healthcare providers may use non-pregnant reference ranges, leading to an underestimation of anemia in pregnant individuals.
Access to and frequency of prenatal care can vary among pregnant women. Those who do not receive regular check-ups may miss opportunities for anemia screening and detection. Inadequate prenatal care can be influenced by various factors, including socioeconomic status, geographic location, and personal circumstances.
Some pregnant women and healthcare providers may be hesitant to address anemia due to concerns about potential side effects of iron supplementation, such as constipation and nausea. This hesitation may contribute to underdiagnosis and undertreatment.
(Dr. Rahul Bhargava, Principal Director & Chief BMT, Fortis Memorial Research Institute, Gurugram)