Vitamin B12 and Iron Deficiencies in Anemia of Pregnancy and Puerperium

Anemia in pregnant women is common particularly in countries where the birth rate is high and malnutrition prevalent. This anemia may be hypochromic due to iron deficiency or may be of the type variously referred to as macrocytic, hyperchromic, megaloblastic, or pernicious anemia of pregnancy. This classification is based on the morphological changes in the peripheral blood and bone marrow and on the response to therapy. In the case of hypochromic anemia the therapeutic response to iron is usually clear-cut, justifying its classification as an iron-deficiency anemia. In the macrocytic anemia of pregnancy, however, the therapeutic response is variable, and this type of anemia has been found to respond to a variety of substances, including crude and refined liver extracts,1-3folic acid,4-9oral and parenteral vitamin B12,10-18a highprotein diet,19and penicillin.20In some anemias of pregnancy neither the morphological changes nor the response to treatment are sufficiently distinct