Abstract Objective. To examine the relationship between maternal haemoglobin concentration (Hb) at 27-29 weeks' gestation and severity of pre-eclampsia (PE). Methods. This was a retrospective study of maternal Hb at 27-29 week in 497 pregnancies that developed PE and 497 healthy controls with normal pregnancy outcomes. Multiple regression analysis was used to examine the association between HB and maternal characteristics and severity of PE classified according to gestation at delivery, birth weight and prevalence of abnormal peripartum maternal creatinine, aspartate transaminase and platelet count. Results. There was no significant difference in median Hb between the PE and control groups. Multiple regression analysis in the PE group showed that significant prediction for Hb was provided by Afro-Caribbean race, gestation at delivery, maternal platelet count <2.5th percentile and birth weight, but not serum creatinine or aspartate transaminase above the 97.5th percentile. Increased Hb was observed in both small and large for gestational age neonates. Conclusion. In PE Hb at 27-29 weeks is influenced by birth weight, maternal characteristics and platelet count.