Aspects of nutritional anaemia in pregnancy in Gambia

1. (1) Eleven patients with anaemias of pregnancy were studied over a period of 4 months. Six with megaloblastic, one with normocytic, and one with microcytic anaemia were given a high protein dietary supplement, but no haematological response was observed. 2. (2) A study of eight patients with tropical macrocytic anaemia of pregnancy and bone marrows containing “transitional megaloblasts” leads to the proposition that two factors are present in the aetiology of this anaemia as found in the Gambia: 1. i. a haemolytic factor, which ceases directly on delivery and, in the production of which past malarial infection can be suspected of playing a part. 2. ii. a failure of utilization of haemopoietic substances in pregnancy which lasts for at least a week after delivery. The findings are thought to provide evidence that, in the Gambia, dietary deficiency of haemopoietic substances, or direct competition for them between foetus and mother, are not major factors in the production of this anaemia.