Background: A well-functioning placenta is important for fetal growth and it’s weight indicates whether it is functioning well or not. High and low placenta to birth weight ratio is found to have adverse fetal outcome. Placental to birth weight ratio can act as an indicator of low maternal hemoglobin concentrations in pregnancy.
 Objectives: To determine the frequency of iron deficiency anemia in pregnant women and to compare the mean ratio of placenta to birth weight in women with iron deficiency anemia versus non-anemic women.
 Study design: Descriptive, cross-sectional study.
 Settings: Department of Obstetrics & Gynecology, Ganga Ram Hospital, Lahore
 Study duration: This study was conducted over a period of 6 months, from October 2019 to March 2020.
 Materials & Methods: A total of 93 women with singleton pregnancy of cephalic presentation, having low hemoglobin were included. Patients with multiple pregnancy, Chronic Liver Disease and Chronic Renal Failure were excluded. In all women 5 milliliters (ml.) blood sample was sent to institutional laboratory for ferritin levels and iron deficiency anemia was noted. After this, placental to birth weight ratio was measured.
 Results: The age range of participants was from 18 to 40 years in this study, the mean of age was 30.48 ± 4.27 years. Most of the patients i.e. 52 (55.91%) were multipara. In this study, the haemoglobin (Hb) <9 gm/dl and serum Ferritin level <15ng/ml was taken as positive for iron deficiency anaemia. The frequency of iron deficiency anemia in pregnant women was found to be (43.01%). Mean ratio of placenta weight to fetal weight in women with iron deficiency anemia versus non-anemic women was found to be 0.20 ± 0.02 versus 0.20 ± 0.01 (p value = 0.804).
 Conclusion: This study concluded that frequency of iron deficiency anemia in pregnant women is quite high with no significant difference of mean placenta to fetal weight ratio in women with iron deficiency anemia as compared to non-anemic women.