Roberts P D, James H, Petrie A, Morgan J O, Hoffbrand A V
Br Med J. 1973 Jul 14;3(5871):67-72. doi: 10.1136/bmj.3.5871.67.
Haemoglobin, serum vitamin B(12), 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 B(12) 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 B(12) 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 B(12) levels. Only one patient, however, had overt megaloblastic anaemia due to vitamin B(12) deficiency. The Indian patients whose red cell folate levels were less than 200 ng/ml also had a lower mean serum vitamin B(12) 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 B(12) status between the two groups. However, out of 39 babies of the Indian group 5 (13%) showed subnormal serum vitamin B(12) 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 B(12) between first booking and 34 weeks of pregnancy there was no significant fall in serum vitamin B(12) in those who initially had subnormal levels. Thus many Indian women are vitamin B(12) deficient in pregnancy, and this is associated with morphological blood abnormalities in many cases, but megaloblastic anaemia due to this deficiency is relatively infrequent.
对伦敦的322名怀孕移民妇女在首次产检时、部分妇女在妊娠34周时以及产后测定了血红蛋白、血清维生素B12、血清和红细胞叶酸水平。印度、东非印度、巴基斯坦和孟加拉国患者的初始血清维生素B12平均水平显著低于欧洲组，印度教和锡克教患者的水平低于穆斯林患者。西印度、印度和东非印度裔患者的初始血红蛋白平均水平显著低于来自欧洲国家的移民。虽然血红蛋白与血清维生素B12水平之间没有总体相关性，但外周血中多分叶核细胞和大细胞增多症的发生率在印度和东非印度患者中最高，并且这两种特征在血清维生素B12水平低于正常的患者中尤为常见。然而，只有一名患者因维生素B12缺乏而出现明显的巨幼细胞贫血。红细胞叶酸水平低于200 ng/ml的印度患者的血清维生素B12平均水平也低于红细胞叶酸水平高于200 ng/ml的患者。印度患者的婴儿比欧洲患者的小，但这与两组之间维生素B12状态的差异无关。然而，在印度组的39名婴儿中，有5名（13%）在出生后的头10天血清维生素B12水平低于正常，最低水平为120 pg/ml。虽然从首次产检到妊娠34周血清维生素B12总体上有统计学意义的下降，但最初水平低于正常的患者血清维生素B12没有显著下降。因此，许多印度妇女在孕期维生素B12缺乏，在许多情况下这与血液形态异常有关，但由于这种缺乏导致的巨幼细胞贫血相对少见。
