Which type of anemia should pregnant patients be aware of due to increased folate requirements?

• A. Iron deficiency anemia
• B. Pernicious anemia
• C. Folate deficiency anemia
• D. Aplastic anemia

Answer: (C)

Folate is essential for DNA synthesis in rapidly dividing cells, and during pregnancy the demand for folate rises to support fetal neural tube development. If intake doesn’t meet this higher need, red cell precursors can’t mature properly, leading to macrocytic anemia known as folate deficiency anemia. That’s why pregnancy is a time when maintaining adequate folate intake is important. This condition is characterized by a higher mean corpuscular volume and hypersegmented neutrophils, with fatigue and pallor as common symptoms. It’s distinct from iron deficiency anemia, which is due to iron shortage and typically microcytic, from pernicious anemia, which is a vitamin B12 deficiency with possible neurologic signs, and from aplastic anemia, which is bone marrow failure causing pancytopenia. So, the increased folate requirements in pregnancy point to folate deficiency anemia, preventable with folic acid supplementation.