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B12 Deficiency is the Commonest Cause of Anaemia During Pregnancy in Northern India: Study from a Tertiary Care Institute

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Abstract

Iron deficiency anemia is considered the leading cause of anemia during pregnancy; however, there is a lack of comprehensive studies on the etiological factors of anemia in pregnant women. The objective of this study was to systematically investigate the causes of anemia in pregnancy. Five hundred women with hemoglobin levels < 11 g/dl between 6 and 40 weeks of pregnancy underwent a complete hemogram, iron studies, serum folate, serum B12, serum copper, and serum zinc level assessments using standard methods. The median age of the patients was 26 years (range 24–29 years). The majority of patients were in the third trimester (449/500, 89.8%). Among the patients, 325 (65%) had vitamin B12 deficiency, with 159 (31.8%) having isolated B12 deficiency and 142 (28.4%) having combined B12 and iron deficiency. Isolated iron deficiency anemia was present in 74 patients (14.8%). Additionally, 28 patients (5.6%) had beta-thalassemia minor, and anemia of chronic disease was found in 17.2% (86) of the patients. Vitamin B12 deficiency was the most common cause of anemia, followed by combined B12 and iron deficiency. Further studies in diverse populations are warranted as they have broader implications for nutrient supplementation during pregnancy.

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References

  1. https://www.who.int/data/nutrition/nlis/info/anaemia (accessed 29th May 2023)

  2. Araujo Costa E, de Paula Ayres-Silva J (2023) Global profile of anemia during pregnancy versus country income overview: 19 years estimative (2000–2019). Ann Hematol. https://doi.org/10.1007/s00277-023-05279-2. Epub ahead of print. PMID: 37233775

  3. Tandon R, Jain A, Malhotra P (2018) Management of iron deficiency anemia in pregnancy in India. Indian J Hematol Blood Transfus 34(2):204–215

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mishra J, Tomar A, Puri M, Jain A, Saraswathy KN (2020) Trends of folate, vitamin B12, and homocysteine levels in different trimesters of pregnancy and pregnancy outcomes. Am J Hum Biol 32(5):e23388

    Article  PubMed  Google Scholar 

  5. Rohilla M, Raveendran A, Dhaliwal LK, Chopra S (2010) Severe anaemia in pregnancy: a tertiary hospital experience from northern India. J Obstet Gynaecol 30(7):694–696

    Article  CAS  PubMed  Google Scholar 

  6. Finkelstein JL, Fothergill A, Krisher JT, Thomas T, Kurpad AV, Dwarkanath P (2021) Maternal vitamin B12 deficiency and perinatal outcomes in southern India. PLoS ONE 16(4):e0248145

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Singh S, Geddam JJB, Reddy GB, Pallepogula DR, Pant HB, Neogi SB, John N, Kolli SR, Doyle P, Kinra S, Ness A, Murthy GVS (2017) Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India. BMC Nutr 26(3):50

    Article  Google Scholar 

  8. Venkatesh U, Sharma A, Ananthan VA, Subbiah P, Durga R (2021) CSIR summer research training team. Micronutrient’s deficiency in India: a systematic review and meta-analysis. J Nutr Sci 10:e110

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Sharma R (2017) Revised Kuppuswamy’s socioeconomic status scale: explained and updated. Indian Pediatr 54(10):867–870

    Article  PubMed  Google Scholar 

  10. Malhotra P, Kumari S, Kumar R, Varma S (2004) Prevalence of anemia in adult rural population of north India. J Assoc Physicians India 52:18–20 (PMID: 15633712)

    CAS  PubMed  Google Scholar 

  11. Barney AM, Abraham VJ, Danda S, Cherian AG, Vanitha S (2020) Prevalence of vitamin B12 deficiency and its associated risk factors among pregnant women of Rural South India: a community-based cross-sectional study. Indian J Community Med. 45(4):399–404

    Article  PubMed  PubMed Central  Google Scholar 

  12. Behere RV, Deshmukh AS, Otiv S, Gupte MD, Yajnik CS (2021) Maternal vitamin B12 status during pregnancy and its association with outcomes of pregnancy and health of the offspring: a systematic review and implications for policy in India. Front Endocrinol 12:619176. https://doi.org/10.3389/fendo.2021.619176. (PMID: 33912132, PMCID: PMC8074968)

    Article  Google Scholar 

  13. Gopal M, Sunitha K, Arockiasamy J, Sibqathulla MJ, Yuvaraj J, Kalyanaraman S (2022) Micronutrient deficiency in pregnancy: time to think beyond iron and folic acid supplementation. Indian J Community Med 47(3):425–428

    PubMed  PubMed Central  Google Scholar 

  14. Jeruszka-Bielak M, Isman C, Schroder TH, Li W, Green TJ, Lamers Y (2017) South Asian ethnicity is related to the highest risk of vitamin B12 deficiency in pregnant Canadian women. Nutrients 9(4):317. https://doi.org/10.3390/nu9040317. (PMID:28333089; PMCID:PMC5409656)

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kaushal S, Priya T, Thakur S, Marwaha P, Kaur H (2022) The etiology of anemia among pregnant women in the hill state of Himachal Pradesh in North India: a cross-sectional study. Cureus 14(1):e21444. https://doi.org/10.7759/cureus.21444. (PMID: 35223229; PMCID: PMC8857868)

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sukumar N, Rafnsson SB, Kandala NB, Bhopal R, Yajnik CS, Saravanan P (2016) Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis. Am J Clin Nutr 103(5):1232–1251 Erratum in: Am J Clin Nutr. 2017; 105(1):241. PMID: 27076577

  17. Finkelstein JL, Kurpad AV, Thomas T, Srinivasan K, Duggan C (2017) Vitamin B12 status in pregnant women and their infants in South India. Eur J Clin Nutr 71(9):1046–1053. https://doi.org/10.1038/ejcn.2017.29. Epub 2017 Apr 12. PMID: 28402324; PMCID: PMC8141370

  18. Krishnaswamy PH, Prabhu S, Pandith NA, Shetty AS (2016) Serum vitamin B12 and folate levels in mothers and their newborns: an observational study. J Postgrad Med Edu Res 50(4):190–193

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Sankalp Hospital, Ambikapur, India

    Ankita Bansal

  2. Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India

    Vanita Suri & Pooja Sikka

  3. Department of Paediatric Biochemistry, PGIMER, Chandigarh, India

    Savita Verma Attri

  4. Department of Haematology, PGIMER, Chandigarh, India

    Neelam Varma

  5. Department of Paediatrics, PGIMER, Chandigarh, India

    Shiv Sajan Saini

  6. Department of Ophthalmology, Sankalp Hospital, Ambikapur, India

    Akshaya Goyal

  7. Department of Clinical Haematology and Medical Oncology, PGIMER, Chandigarh, 160012, India

    Pankaj Malhotra

Authors
  1. Ankita Bansal
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  2. Vanita Suri
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  3. Pooja Sikka
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  4. Savita Verma Attri
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  5. Neelam Varma
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  6. Shiv Sajan Saini
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  7. Akshaya Goyal
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  8. Pankaj Malhotra
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Contributions

Dr. AB and Dr. VS conceived the present idea and designed the study. Dr. PM planned the test, contributed to the design, and helped in the analysis. Dr. NV and Dr. SVA carried all the biochemical tests. Dr. PS and Dr. SSS supervised the research findings. Dr. AG took the lead in writing the manuscript and analysis. All the authors provided critical feedback and helped shape the research, analysis, and manuscript.

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Correspondence to Pankaj Malhotra.

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Bansal, A., Suri, V., Sikka, P. et al. B12 Deficiency is the Commonest Cause of Anaemia During Pregnancy in Northern India: Study from a Tertiary Care Institute. Indian J Hematol Blood Transfus 40, 78–82 (2024). https://doi.org/10.1007/s12288-023-01682-x

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  • DOI: https://doi.org/10.1007/s12288-023-01682-x

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