Megaloblastic anemia of pregnancy: characteristics of pure megaloblastic anemia and megaloblastic anemia associated with iron deficiency.

LTHOUGH megaboblastic anemia of pregnancy is considered mainly as a folic acid deficiency anemia, since this vitamin induces remission in most cases, its mechanism of production is still obscure. Dietary deficiency has been claimed to be the principal cause. However, this anemia has been observed in well-to-do women whose diet was satisfactory. Some other factors such as gastrointestinal upset, repeated pregnancies, hemorrhages, infections and toxemia have been reported as contributing to the development of vitamin deficiency. In Venezuela, Laynisse and Aguero have found 38 cases of megaloblastic anemia of pregnancy out of 1000 cases of anemic pregnant women, which, with the incidence published by Lilbie et al.’ in Dublin, represents the highest frequency of this disorder yet found in the available literature. The clinical and hematoiogic data of the first 20 cases have already been published.2 Seventeen of the last 18 cases were studied in more detail with special reference to the metabolism of iron, vitamin B12 and fobic acid, as well as studies of hemolysis and treatment. The results provide information on the pathophysiology of this anemia in Venezuela and perhaps in other countries with similar geographic or social conditions.