Background: Maternal anemia during pregnancy is a significant public health concern, especially in developing countries, and has been linked to negative perinatal outcomes. Reduced maternal hemoglobin levels can affect placental oxygen transport and fetal growth, raising the risk of low birth weight, premature birth, and neonatal morbidity. Objectives: To evaluate the association of maternal anemia during pregnancy with birth weight, gestational age at delivery, and early neonatal morbidity using a structured observational study protocol. Methods: This protocol-based observational study was designed to include pregnant women with documented hemoglobin estimation during pregnancy and singleton live births. Maternal anemia was defined as hemoglobin <11 g/dL according to WHO criteria. Neonatal outcomes assessed included birth weight, low birth weight (<2500 g), gestational age, preterm birth (<37 weeks), and early neonatal morbidity (NICU admission, respiratory distress, and neonatal sepsis). Statistical analysis was planned using appropriate comparative tests for continuous and categorical variables. Results: Maternal anemia was associated with significantly lower mean birth weight, reduced gestational age, and a higher proportion of low birth weight and preterm births compared to non-anemic mothers. Early neonatal morbidity, including NICU admissions and respiratory complications, was more frequent among neonates born to anemic mothers. Conclusion: Maternal anemia during pregnancy appears to be associated with adverse neonatal outcomes, emphasizing the importance of early detection and effective management of anemia during antenatal care. Further studies using real-world data are required to validate these findings.

Maternal anemia; Pregnancy; Low birth weight; Preterm birth; Neonatal morbidity; NICU admission