Megaloblastic anemia in pregnancy is caused by deficiency of which nutrients?

• A. Iron only
• B. Folic acid or vitamin B12
• C. Vitamin C
• D. Vitamin D

Answer: (B)

Megaloblastic anemia occurs when DNA synthesis in rapidly dividing cells, like red blood cell precursors, is defective. In pregnancy, the need for folic acid rises to support fetal development, and vitamin B12 is essential for proper DNA synthesis. Deficiency of either folic acid or vitamin B12 interrupts DNA replication, causing enlarged, immature red cells (megaloblasts) and a macrocytic anemia. This is distinct from iron deficiency, which causes microcytic anemia, and from deficiencies of vitamin C or vitamin D, which affect other systems and do not produce megaloblastic RBC findings. In practice, addressing folate and B12 levels and providing appropriate supplementation prevents or treats this type of anemia during pregnancy.