Iron deficiency and iron supplementation are well known but unresolved issues of perinatal care. Approximately one thousand articles listed in Medline® over the last ten years focus on iron and pregnancy. Clearly, there are many unresolved questions regarding perinatal iron deficiency and iron supplementation.

Despite substantial advances in pre- and postnatal care, the problem of preterm labour continues to be a significant medical, economic and social burden. Globally, it is estimated that 13 million babies are born preterm each year, but the incidence varies substantially between different countries and population groups. In the United States alone, approximately 11% of pregnancies, i.e. 380,000 cases annually are delivered after preterm labour and in Europe the overall incidence is believed to be approximately 6%, representing an annual population of 375,000. The main complication of very early preterm birth to the newborn is immaturity of different organs, in particular incomplete maturation of the lungs. However, a recent multi-centre surveillance study demonstrated that also modest degrees of prematurity are associated with developmental delays, implying that adequate intrauterine maturation of the fetus is vital to postnatal development.

Improved diagnosis and corrective cardiac surgery has led to an increasing number of women with congenital heart diseases reaching reproductive age. Pregnancy places considerable strain on the heart and circulation, requiring marked cardiorespiratory adaptation. Today, with the exception of the Eisenmenger syndrome, there is no increased mortality associated with pregnancy in congenital heart disease. In contrast, there is still considerable morbidity, due to congestive heart failure, thromboembolic complications and disturbances of rhythm.

Since the first report by Simpson (1957) of the association between premature birth and maternal smoking, the research on the consequences of maternal smoking during pregnancy on perinatal outcome has been intense. Even if some of the findings have been contradictory, it is now evident that maternal smoking is associated with pre-term birth and low birth weight, low birth weight for gestational age, small head circumference, low Apgar score at 5 min, stillbirth and neonatal death.