Does anaemia increase the risks to the fetus caused by smoking in pregnancy?

A significantly greater rise in carboxyhaemoglobin concentration in response to smoking a single cigarette was shown in pregnant (3-9% increase) as opposed to non-pregnant (2-1% increase) women. This was more pronounced when anaemia was present (5-0% increase) and appeared to be inversely related to the haemoglobin concentration. We suggest that the risks to the fetus may be particularly increased when anaemia complicates pregnancy in women who smoke cigarettes.