Response to comments on: Rohilla M, Raveendran A, Dhaliwal LK, Chopra S. 2010. Severe anaemia in pregnancy: a tertiary hospital experience from northern India. Journal of Obstetrics and Gynaecology 30:694–696

Dear Sir,

We appreciate the comments and concerns that our paper has stimulated and are pleased to respond to the constructive comments of Professor Ishag Adam. Prevalence of anaemia in India is among the highest in the world. We undertook this study to find whether severe anaemia is an independent predictor of maternal and perinatal morbidity and mortality in pregnancy and the outcomes were compared with the overall hospital maternal data (Rohilla et al. 2010). We agree that malaria during pregnancy is a recognised risk factor for maternal and fetal complications and it is endemic in certain areas of India (Seal et al. 2010). In all the 96 women, peripheral blood film was done and none showed the presence of a malarial parasite and moreover, studies from India had related low socioeconomic status, low educational attainment and poor health-seeking behaviour of these women as a risk factor contributing to the high prevalence of anaemia during pregnancy, and none attributed it to malaria (Swami et al. 1998; Noronha et al. 2010; Rohilla et al. 2010.). The ≥ 3-fold increase in the incidence of pre-eclampsia is our observation and we attribute it to maternal vascular dysfunction, which is also implicated in intrauterine fetal growth restriction (Steer 2000). Current data indicate that iron deficiency anaemia is a risk factor for pre-term delivery, low birth weight and neonatal anaemia. Anaemia remains a huge health problem and preventing or reducing the impact of it remains a goal and challenge.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.