Iron deficiency anemia (IDA) remains the most common hematologic disorder during pregnancy and one of the leading causes of maternal and perinatal complications worldwide. The increased iron demand associated with fetal growth, placental development, and maternal blood volume expansion often exceeds dietary intake, leading to progressive depletion of iron stores and the development of anemia. Severe IDA is associated with significant risks, including maternal fatigue, cardiovascular strain, infection, preterm labor, low birth weight, and impaired neonatal neurodevelopment. This review summarizes current international evidence from 2015 to 2025 on the clinical course, diagnosis, outcomes, and management of severe iron deficiency anemia in pregnant women, emphasizing WHO, ACOG, and FIGO guidelines. Analysis of recent studies indicates that timely screening, measurement of hemoglobin and ferritin levels, and individualized iron supplementation—preferably oral for mild to moderate cases and intravenous for severe anemia—are essential for improving maternal and fetal outcomes. Despite progress in prevention and treatment strategies, severe IDA continues to represent a significant challenge in obstetric practice, highlighting the need for stronger implementation of standardized screening protocols and broader access to evidence-based care.

pregnancy, hemoglobin, maternal health

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