Background: Persisting burden of anaemia during pregnancy, global public health concern, is commonest disorder globally. Severe anaemia is potentially fatal for mother and baby.

Objective: Present study was carried out to know about burden of anaemia and perinatal outcome in rural tribal pregnant women.

Material methods: Prospective community based study was conducted in 100 villages, where mother, child care services were initiated after having created a health facility in one, using pretested tool to get information required as per objectives.

Results: Of 3713 women who delivered, 2617 (70.5%) were anaemic, 1351 (36.4%) mildly, 964 (26.0%) moderately, 211 (5.7%) severely and 91 (2.5%) very severely anaemic during pregnancy. Amongst 2617 anaemic women, 8.6% had Preterm (PT), 91.4% term births, 4% of 225 PT were Intra Uterine Foetal Deaths (IUFDs), 0.9% of 2392 term IUFDs, seventeen (7.5%) of 225 PT babies were Stillborn (SB), 5.2% of 2392 term SB, 78.6% of 225 PT were Low Birth Weight (LBW), 73.4% of 2392 term LBW, 70.2% of 225 PT were Small for Gestational Age (SGA) babies and 36.5% of 2392 term SGA. Total 1.8% babies had early Neonatal Deaths (NNDs) and 0.7% late NNDs. Amongst 1096 non-anaemic women, 1.3% had PT, 98.7% term births, no IUFD, All 14 PT births were SB, 3.9% term born were SB, 1.2% PT were LBW, 30.5% term LBW, 0.6% PT SGA, 3.8% term SGA. Total 0.09% early NNDs occurred in non-anaemic women. Of 10 women who died, five had severe anaemia, three of them died of post-partum haemorrhage, one congestive cardiac failure, one puerperal sepsis with multi-organ failure.

Conclusion: Anaemia was very common in rural tribal pregnant women, quite a few were very severely anaemic with many LBW, SGA babies, perinatal and maternal deaths.