Serum levels of folic acid, vitamin B12, and iron in anemia of pregnancy

alpha-Thalassemia 2, 3.7 kb deletion and hemoglobin AC heterozygosity in pregnancy: a molecular and hematological analysis

alpha-Thalassemia is a synthesis hemoglobinopathy with a worldwide distribution. alpha-thalassemia-23.7kb (alpha-Thal23.7kb) was investigated by PCR and standard hematologic analysis techniques in 106 pregnant women - 53 heterozygous for hemoglobin (Hb) A and C (AC) and 53 homozygous for the normal Hb A (AA) with similar ages and race ancestry. Eleven (21%) of AC women were alpha-Thal23.7kb heterozygous and 1 (2%) was homozygous, while 12 AA women (23%) were heterozygous. In the AA group, the MCV differed among those with normal alpha genes and those with alpha-Thal23.7kb (P = 0.031). Statistical analysis of AC group patients with normal alpha genes and alpha-Thal23.7kb carriers showed differences in MCV (P = 0.001); MCH (P = 0.003) and Hb C concentrations (P = 0.011). Analysis of AA and AC group patients with normal alpha genes showed differences in RBC (P = 0.033), Hb concentration (P = 0.003) and MCHC (P < 0.0001). There were no statistically significant differences for any hematologic parameters between AC and AA group patients with the alpha-Thal23.7kb genotype. The AC alpha-Thal23.7kb homozygous women had low hematologic parameters. Serum ferritin levels were normal among the groups studied. These results emphasize the importance of diagnosis and follow-up of patients with hemoglobinopathy carriers during pregnancy in order to administer adequate therapy and avoid further complications for mothers and newborns.

Investigation of red cell size-distribution histograms related to folate, vitamin B12 and iron state in the course of pregnancy

Effects of gradually reduced stores of iron, folate or vitamin B12 on the erythron were investigated in the course of pregnancy in 23 subjects. Significant decreases in serum concentrations of the compounds above were shown at 20 weeks of gestation with a further decline later. An increased value for the microcyte fraction was established in two subjects, whereas seven other subjects showed increased values for the macrocyte fraction. As pregnancy proceeded a significant intra-individual change could be detected in the microcyte fraction in only one subject. In three of the seven above-mentioned subjects, the values measured for the macrocyte fraction demonstrated a further slight increase during the course of pregnancy. Values established for the absolute distribution width at half peak height (ADW0.5) did not reveal significant changes in the course of pregnancy. If compared with the mean cell volume (MCV) and ADW0.5 values, the microcyte and macrocyte fraction respectively may yield a sensitive and specific indication of anomalies of the erythron. Changes in successively determined haemocytometric values in several pregnant women might indicate decreased availability of nutrients for erythropoiesis. However, one may not draw definite conclusions because it is doubtful whether the condition of the stores in these circumstances will be reflected accurately by the corresponding serum concentrations.

Folic acid deficiency in the United States: folate assays in a prenatal clinic

Tissue deficiency of folic acid, as measured by a red cell folate level below 150 ng. per milliliter, was present in 16 per cent of 110 sequential pregnant women at the time of their first prenatal visit to a municipal clinic. A further 14 per cent of subjects had red cell folate levels in the range "suggestive but not conclusive for tissue folate depletion" (150 to 199 ng. per milliliter). All of the subjects were from low-income families in New York City and most were black or of Puerto Rican origin. Serum folate levels showed good general correlation with red cell folate but were of less value as a diagnostic test, since they were below the lower limit of normal in 64 per cent of subjects, including many subjects who did not yet have low tissue folate. In contrast to their value in other folate deficiency states, neutrophil lobe counts showed no correlation with serum or red cell folate levels in pregnancy and thus appeared of little diagnostic value in pregnancy. It is suggested that surveys of folate deficiency in other pregnant population groups in the United States be carried out. These results support the recommendations of the Committee on Maternal Nutrition and the Committee on Dietary Allowances of the Food and Nutrition Board, National Research Council (U.S.A.) that folic acid supplements (200 to 400 mug per day) should be taken throughout pregnancy.

[Iron-deficiency anemia in pregnant women and newborn infants]

O objetivo proposto foi verificar a prevalência de deficiência de ferro, num estrato de parturientes e recém-nascidos do município de São Paulo, de características sócio-econômicas bem definidas. O levantamento bioquímico constituiu-se de dosagens de concentração de hemoglobina, hematócrito, ferro sérico e capacidade de ligação de ferro. Os resultados desse levantamento mostraram uma prevalência de 52,3% de anemia em parturientes e de 21% de anemia em recém-nascidos. Concluiu-se que a ministração de sais de ferro, em serviços especializados de atendimento às gestantes pertencentes a classe sócio-econômica semelhante à essa estudada, seria uma medida profilática que poderia diminuir essas porcentagens de anemia.

[Hemoglobin curve in a group of normal pregnant women]

Através das dosagens de hemoglobina realizadas em várias épocas da gravidez, em 701 gestantes sem suplementação de ferro escolhidas por amostragem casual simples de um universo de 7050 no período de 1947 a 1969, foi construída uma curva com as taxas médias de hemoglobina, que evidenciou uma queda que atinge o máximo por volta do 7.° mês de gravidez e elevando-se a partir desta época. A partir dela foi construída uma curva operacional e discutida a sua importância no diagnóstico e conduta frente a anemia na gravidez.

Pregnancy and untreated Addisonian pernicious anemia

The case histories are given of two patients, aged 38 and 35 years, who conceived while suffering from Addisonian pernicious anaemia. The relationship of these findings to the routine use of folic acid during pregnancy is discussed.