Behind the veil of anemia: Assessment of iron, folic acid, and vitamin B12 deficiencies and their association with red cell indices in anemic and non-anemic women

Abstract

During pregnancy anemia is a common health issue with various factors influencing its occurrence. It is a major public health problem in India. It is believed that 2.36 billion individuals are affected globally, and it is also an endemic problem in India. Iron deficiency often leads to iron deficiency anemia (IDA), significantly influencing maternal and fetal health.This study aims to investigate the complete blood count and nutritional parameters including Iron profile, vitamin B12, and Folic acid in anemic and non-anemic participants.The study involved 458 women of which 300 were anemic women and 158 were non-anemic women, predominantly from rural areas. The severity of anemia was classified as per WHO guidelines. The CBC was estimated by a 3-part hematology analyzer Medonic M-series, while the iron profile, vitamin B12, and folic acid were measured by using an automated analyzer Abbott Architect 1000 SR.The severity of anemia among the anemic women, classified according to WHO guidelines, revealed that 38.7% had mild anemia, 32.7% had moderate anemia, and 28.6% had severe anemia. 39.3% women exhibited microcytic hypochromic cells, 38% had normocytic normochromic cells, and 22.7% exhibited macrocytic cells. 56.6% had iron deficiency, 10% had folate deficiency, 16.7% had vitamin B12 deficiency, 6.7% had iron+vitamin B12+folic acid deficiency and 10% had vitamin B12+folic acid deficiency. Based on the severity only vitamin B12 was significantly reduced in severe (145.65±58.43) than moderate (177.06±66.24) and mild group (174.43±68.43), p=0.042. Hemoglobin showed a positive correlation with iron level (r=0.523, p<0.0001), and a negative correlation with ferritin (r=-0.355, p<0.0001).: These findings provide valuable insights into the nutritional status of the anemic women and highlights the need for targeted interventions to address micronutrient deficiencies during pregnancy.