Iron, folic acid, and vitamin B12 deficiencies and their association with red cell indices

Anemia during pregnancy is a prevalent health issue influenced by various factors, posing a significant public health challenge in India. Globally, approximately 2.36 billion individuals are affected, with India facing endemic levels. Iron deficiency is a primary cause of iron deficiency anemia (IDA), severely impacting maternal and fetal health.

A recent study aimed to examine the complete blood count (CBC) and nutritional parameters, including iron profile, vitamin B12, and folic acid, in both anemic and non-anemic women.

The study included 458 pregnant Indian women – 300 anemic and 158 non-anemic––predominantly from rural areas visiting a State Medical College at Shahjahanpur. Anemia severity was categorized based on the World Health Organization (WHO) guidelines. All participants underwent assessments for complete blood count (CBC), iron profile, vitamin B12, and folic acid levels.

Among the anemic women, 38.7% had mild anemia, 32.7% had moderate anemia, and 28.6% had severe anemia. Cell morphology showed 39.3% with microcytic hypochromic cells, 38% with normocytic normochromic cells, and 22.7% with macrocytic cells. Deficiencies detected were as follows – 56.6% had iron deficiency; 10% had folate deficiency; 16.7% had vitamin B12 deficiency; 6.7% had combined iron, vitamin B12, and folic acid deficiencies; and 10% had combined vitamin B12 and folic acid deficiencies. Vitamin B12 levels were significantly lower in the severe anemia group compared to the moderate and mild groups. Hemoglobin levels positively correlated with iron levels and negatively with vitamin B12.

The results highlight anemia prevalence and the associated micronutrient deficiencies among Indian pregnant women, underscoring the need for targeted interventions like food fortification and health education. These findings offer critical insights into anemia management and suggest directions for future research.

Source: Sharma M, Frayez M, Rahman A, et al. Indian J Obstet Gynecol Res 2024;11(2):172-177