Which of the following is not listed as a cause of Addisonian crisis in pregnancy?

• A. Hyperemesis gravidarum
• B. Infection
• C. Delivery
• D. Anemia

Answer: (D)

In pregnancy, Addisonian crisis occurs when the body cannot mount enough cortisol in response to a stressor, leading to shock and electrolyte imbalances. The common precipitants are physiologic stresses that increase the body's need for cortisol: vomiting with dehydration from hyperemesis gravidarum, systemic stress from an infection, and the major stress of delivery. Anemia, while an important obstetric concern, does not directly provoke an adrenal crisis because it doesn't acutely compromise adrenal cortisol production or create the immediate cortisol shortfall that triggers a crisis.