Q. My hemoglobin dropped to 5. 5 g/dL at 27 weeks of pregnancy. Will it affect my fetus?

Answered by
Dr. Utkarsh Sharma
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Mar 07, 2021 and last reviewed on: Mar 27, 2021

Hi doctor,

I am 27 weeks pregnant and my hemoglobin has come down 3 units. It was 8.9 g/dL and has come down to 5.5 g/dL. I had taken injection Iron Sucrose 1.2 g and injection FCM 1 g under specialist supervision. But still, there is no increase in hemoglobin. The PBS report says macrocytic anemia and anisopoikilocytosis. Sir please let me know whats the problem.



Welcome to

I understand your case and will help you with it. Yours is a case of iron deficiency anemia (IDA) along with coexisting macrocytic anemia. Iron replacement therapy alone may not work unless the cause of macrocytic anemia is corrected.

Iron is the element needed for RBC (red blood cells) formation, but vitamin B12 and folic acid are also necessary for efficient development. Are you taking Folic acid supplements already? Did you get your vitamin B12 and folic acid levels done? Such deficiency is more common in vegans and vegetarians. I will suggest B12 and folic acid levels first and then report back. Just to mention, there will be slightly low hemoglobin in pregnancy than normal anyways due to hemodilution. I hope you get well soon.

Thank you doctor,

My vitamin B12 is 208 pg/mL, and I had done it one week back. Will it affect my baby, and will there be any congenital or neural tube defect? Anomaly scan and triple markers were normal. I used to take Folic acid intermittently, and even now, I am taking it. I am worried about my baby, and I even got transfused last week. Two units of blood and only an increase in 1 gram of hemoglobin were found. Now my hemoglobin is 6.4 g/dL.



Welcome back to

Your vitamin B12 level is borderline normal. There is no risk as of now due to vitamin B12 levels. It is good that you got done a triple marker test and anomaly scan. If you could send your complete blood count report as an attachment, it would be easier for me to interpret. What was your Hb level before you conceived? I suggest you continue popping Folic acid regularly.

Besides this, aim for at least three servings a day of iron-rich foods, such as lean red meat, poultry, fish, leafy green vegetables (such as spinach, broccoli, and kale), iron-enriched cereals and grains, beans, lentils, and tofu, nuts and seeds, and eggs. Foods that are high in vitamin C can help your body absorb more iron. These include citrus fruits and juices, strawberries, kiwis, tomatoes, and bell peppers. Try eating those foods at the same time that you eat iron-rich foods. For example, you could drink a glass of orange juice and eat an iron-fortified cereal for breakfast. Also, choose foods that are high in folate to help prevent folate deficiency. These include leafy green vegetables, citrus fruits and juices, dried beans, bread and cereals fortified with folic acid.

All the best and take care.

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