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Abstract : Doppler assessment may lead to intervention that reduces the risk of fetal brain damage. Aim of thestudy: to assess the relation between ultrasonic hemodynamic Doppler indices of middle cerebral and umbilical arteries (PI, RI), growth indices to immediate neonatal outcomes (weight, head & abdominal circumference, APGAR scores at 1 and 5 minutes and neonatal unit admission) in women with mild, moderate and severe anemia during pregnancy. Present study is a clinical prospective study carried out in Al-Elwiya Maternity Teaching Hospital during (January-Jun) 2019, all anemic pregnant women presented to Obstetrical wards in hospitals for emergency cesarean section were the study population. The final sample selected was 120 pregnant women. Ultrasound Doppler velocimetry measurements like middle cerebral artery-peak systolic velocity (MCA-PSV), middle cerebral artery-pulsatility index (MCA-PI), middle cerebral artery-resistance index (MCA-PR), umbilical artery-pulsatility index (UA-PI), umbilical artery- resistance index (UA-RI), middle cerebral artery to umbilical artery- resistance index ratio (MCA/UA-RI) and middle cerebral artery to umbilical artery- pulsatility index ratio (MCA/UA-PI) were measured. Neonates with less than7had low vital activities (appearance, pulse, grimace, activity, and respiration). Mean MCA-PI of anemic pregnant women with severe anemia was 1.4ms which was significantly lower than pregnant women with mild and moderate anemia, also mean MCA/UA-PI of anemic pregnant women with severe anemia was significantly lower than mild and moderate anemia with p-value <0.001. as well as the Mean neonatal HC of anemic pregnant women with severe anemia 30 cm which was significantly lower than HC of pregnant women with mild and moderate anemia (p=0.04), also mean neonatal AC of pregnant women with mild, moderate and severe, Current study showed no statistical difference in Apgar scores between the studies group, The validity results of MCA/UA-PI ratio regarding neonatal HC of anemic pregnant women are Sensitivity (22.2%), specificity (41.7%). Severe maternal anemia is found significantly associated with abnormal Doppler study middle cerebral artery to umbilical artery pulsatility index. so Doppler middle cerebral artery to umbilical artery pulsatility index has limited validity in the prediction of neonatal outcomes in anemic pregnant women.