Papers And Originals

Vitamin B12 Status in Pregnancy among Immigrants to Britain

Br Med J 1973; 3 doi: (Published 14 July 1973) Cite this as: Br Med J 1973;3:67
  1. P. D. Roberts,
  2. Helen James,
  3. Aviva Petrie,
  4. J. O. Morgan,
  5. A. V. Hoffbrand


    Haemoglobin, serum vitamin B12, and serum and red cell folate levels have been measured in 322 pregnant immigrant women in London at their first booking and in a proportion at 34 weeks of gestation and postnatally. The Indian, East-African Indian, and Pakistani and Bangladeshi patients showed significantly lower initial mean serum vitamin B12 levels than the European group, the levels being lower in Hindu and Sikh patients than in Moslems. The patients of West Indian, Indian, and East-African Indian origin showed significantly lower initial mean haemoglobin levels than the immigrants from European countries. Though there was no overall correlation between haemoglobin and serum vitamin B12 level the incidence of hypersegmented polymorphs and macrocytosis in the peripheral blood was highest in the Indian and East-African Indian patients, and both these features were particularly frequent in patients with subnormal serum vitamin B12 levels. Only one patient, however, had overt megaloblastic anaemia due to vitamin B12 deficiency. The Indian patients whose red cell folate levels were less than 200 ng/ml also had a lower mean serum vitamin B12 level than those with red cell folate levels greater than 200 ng/ml. The Indian patients had smaller babies than the Europeans but this was not related to the differences in vitamin B12 status between the two groups. However, out of 39 babies of the Indian group 5 (13%) showed subnormal serum vitamin B12 levels in the first 10 days of life, the lowest level being 120 pg/ml.

    Though there was an overall statistically significant fall in serum vitamin B12 between first booking and 34 weeks of pregnancy there was no significant fall in serum vitamin B12 in those who initially had subnormal levels. Thus many Indian women are vitamin B12 deficient in pregnancy, and this is associated with morphological blood abnormalities in many cases, but megaloblastic anaemia due to this deficiency is relatively infrequent.