Anemia in pregnancy is a major public health concern, especially in developing countries. During the second trimester, plasma volume expansion and increased fetal iron demands predispose women to anemia. Early identification and management are crucial to prevent adverse pregnancy outcomes such as preterm birth, low birth weight, and maternal morbidity.

Study Design Hospital-based cross-sectional study. Study Setting Department of Obstetrics and Gynecology, Tertiary Care Teaching Hospital. Study Duration 6 months. Study Population Pregnant women in the second trimester (13–28 weeks gestation). Sample Size 200 participants. Inclusion Criteria • Singleton pregnancy. • Gestational age between 13 and 28 weeks. • Willing to provide informed consent. Exclusion Criteria • Multiple pregnancy. • Known hematological disorders. • Chronic medical illnesses affecting hemoglobin levels. Data Collection The following variables were recorded: • Maternal age • Gestational age (weeks) • Gravidity and parity • Socioeconomic status • Dietary habits • Inter-pregnancy interval • Iron-folic acid supplementation compliance • Hemoglobin level (g/dL) WHO Classification of Anemia • Mild: 10–10.9 g/dL • Moderate: 7–9.9 g/dL • Severe: <7 g/dL Statistical Analysis Data were analyzed using SPSS version 25. Chi-square test was applied. A p-value <0.05 was considered statistically significant.

Table 1: Distribution According to Gestational Age Gestational Age Number (%) 13–16 weeks 52 (26%) 17–20 weeks 68 (34%) 21–24 weeks 48 (24%) 25–28 weeks 32 (16%) Total 200 (100%) Table 2: Hemoglobin Status Hemoglobin Status Number (%) Normal 84 (42%) Mild Anemia 60 (30%) Moderate Anemia 48 (24%) Severe Anemia 8 (4%) Total 200 (100%) Table 3: Risk Factors Associated with Anemia Risk Factor Anemic (%) p-value Multiparity 67% 0.02 Low socioeconomic status 72% 0.01 Short inter-pregnancy interval (<2 years) 69% 0.03 Poor IFA compliance 81% 0.001

The present study found that 58% of second trimester pregnant women were anemic. Similar findings have been reported in several Indian studies. Increased iron demand during the second trimester contributes significantly to the development of anemia. Multiparity, poor socioeconomic status, and inadequate iron supplementation were major contributing factors.

Anemia is highly prevalent among second trimester pregnant women. Routine screening during antenatal visits, nutritional counseling, and strict adherence to iron-folic acid supplementation are recommended to reduce the burden of anemia and improve pregnancy outcomes.

1. World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: WHO; 2011. 2. World Health Organization. Global anaemia estimates, 2021 edition. Geneva: WHO; 2023. 3. Ministry of Health and Family Welfare. Anemia Mukt Bharat: Intensified National Iron Plus Initiative Operational Guidelines. New Delhi: Government of India; 2021. 4. International Institute for Population Sciences (IIPS), ICF. National Family Health Survey (NFHS-5), 2019–21: India Report. Mumbai: IIPS; 2021. 5. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 26th ed. New York: McGraw-Hill Education; 2022. 6. Dutta DC. Textbook of Obstetrics. 10th ed. New Delhi: Jaypee Brothers Medical Publishers; 2023. 7. Balarajan Y, Ramakrishnan U, Ozaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle-income countries. Lancet. 2011;378(9809):2123-35. 8. Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women. Lancet Glob Health. 2013;1(1):e16-e25. 9. Kalaivani K. Prevalence and consequences of anaemia in pregnancy. Indian J Med Res. 2009;130(5):627-33. 10. Toteja GS, Singh P, Dhillon BS, Saxena BN, Ahmed FU, Singh RP, et al. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food Nutr Bull. 2006;27(4):311-15. 11. Patel KV. Epidemiology of anemia in older adults. Semin Hematol. 2008;45(4):210-17. 12. Allen LH. Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr. 2000;71(5 Suppl):1280S-1284S. 13. Breymann C. Iron deficiency anemia in pregnancy. Semin Hematol. 2015;52(4):339-47. 14. Kumar KJ, Asha N, Murthy DS, Sujatha MS, Manjunath VG. Maternal anemia in various trimesters and its effect on newborn weight and maturity. Int J Prev Med. 2013;4(2):193-99. 15. Lone FW, Qureshi RN, Emmanuel F. Maternal anaemia and its impact on perinatal outcome. Trop Med Int Health. 2004;9(4):486-90. 16. Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, et al. Maternal anemia and risk of adverse birth and health outcomes. Nutrients. 2016;8(4):221. 17. Gautam VP, Bansal Y, Taneja DK, Saha R. Prevalence of anemia amongst pregnant women and its socio-demographic associates in a rural area of Delhi. Indian J Community Med. 2002;27(4):157-60. 18. Noronha JA, Al Khasawneh E, Seshan V, Ramasubramaniam S, Raman S. Anemia in pregnancy—consequences and challenges. Int J Pharm Res. 2012;4(1):64-70.