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Folic Acid Metabolism in Well-Nourished Pregnant Women

From the Department of Internal Medicine (Simpson Memorial Institute), and the Department of Obstetrics and Gynecology. The University of Michigan Medical Center, Ann Arbor, Mich 48104
*Address reprint requests to Doctor Ledger

Abstract

Eighty-five pregnant patients in a well-nourished population were evaluated for folic acid deficiency, utilizing the tests of plasma folate, neutrophil lobe counts, and whole blood cell folate. The values obtained were compared with those of nonpregnant control patients, of patients with documented megaloblastic anemia due to folic acid deficiency, and of fetal blood from the newborns of the pregnant study group. Twenty-one per cent of the pregnant patients developed low plasma folate levels, a statistically significant difference from the nonpregnant controls. No evidence of significant tissue depletion of folate was seen and cord samples from the infants had high plasma and red cell folates. In this group of study patients, no complications of pregnancy were associated with a low plasma folate. Such early folate deficiency in a selected group of well-nourished pregnant patients suggests that routine supplementation with folic acid is probably indicated in our society. It would be particularly useful among patients of low socioeconomic levels, as well as in gravidas with conditions requiring increased amounts of folic acid.