Daniel E. Scott

The effects of maternal sickle cell hemoglobinopathies and sickle cell trait on reproductive performance

Abstract Reproductive performances have been analyzed for 797 black women whose red cells contain sickle cell hemoglobin. Fifty pregnancies in 34 women with sickle cell anemia yeilded only 27 infants who survived; there were no maternal deaths, but morbidity was frequent and often intense. Seventy-eight pregnancies in 43 women with sickle cell-hemoglobin C disease culminated in the births of 68 infants who survived; serious maternal morbidity was common, and 2 women died. Thirty-two infants survived from 37 pregnancies in 21 women with sickle cell-beta thalassemia disease; maternal morbidity was comparable to that with sickle cell-hemoglobin C, disease but there were no maternal deaths. The pregnancy experiences for women with sickle cell trait were not different from those of black women whose red cells do not sickle except for twice the frequency of significant bacteriuria. Thus, the only major cause for special concern by women with sickle cell trait who contemplate reproduction is their potential for transmission of one gene for sickling to the off spring.

Maternal folate deficiency and pregnancy wastage: IV. Effects of folic acid supplements, anticonvulsants, and oral contraceptives

A group of studies on indigent hospital patients were conducted on the role of folate supplements, pregnancy and oral contraceptives in megaloblastic anemia. First 25 pregnant women, given 500 mg iron dextran and 30 mg folic acid for 2-3 months, had 12.4% hemoglogin at delivery, compared with 49 women given only iron who had 12.5% hemoglobin, and 49 untreated women who had 11.3% hemoglobin. Second, plasma folate levels in groups of pregnant women were compared: mean folate was 4.7 ng/ml in 82 normal women, 3.1 in 21 treated epileptics, and about 1.2 in 31 women with megaloblastic anemia. In 77 pregnancies in 43 epileptic women there were no reasons to blame low folate levels for pregnancy wastage since no abruptio placentae or bleeding occurred; and incidence of low birth weight, perinatal death, and prematurity was lower than in the general population. Third, the effect of oral contraceptives on folate levels was observed. Mean plasma folate levels were 8.1 ng/ml in 55 control women, 8.0 in 57 women using the pill, 4.7 in normal women in late pregnancy, and about 1.1 in pregnant women with megaloblastic anemia. Fourth, mean hemoglobin levels rose from 7.6 to 13.4 9m/100 ml within a few weeks in 5 women with gestational megaloblastic anemia after treatment with normal diet, without supplement, and oral contraceptives. One woman with puerperal megaloblastic anemia failed to respond to a regular diet while taking Ovulen, 6 tablets daily. The results suggest that plasma folate levels were neither lower in oral contracepting women nor did the pill prevent the increase in folate in megaloblastic anemia patients treated with diet. Thus the authors concluded that folate supplement is not needed for pill users.

Effect of ingestion of starch and some clays on iron absorption

Abstract The effect of Argo gloss starch and of 2 popular clays on the absorption of a standard dose of ferrous iron was measured in women with iron-deficiency anemia and in normal subjects. The ingestion of sizable amounts of the starch or clays just prior to the iron did not appreciably impair iron absorption. Therefore, if the laundry starch contributes to the development of iron-deficiency anemia, it most likely does so simply by providing calories without iron rather than by impairing iron absorption. Although the 2 popular regional clays studied did not reduce the amount of iron absorbed, the ingestion of some clays has been demonstrated by others to do so. A red clay containing considerable iron proved to be ineffective for correcting iron-deficiency anemia.

The influence of maternal folate and iron deficiencies on intrauterine life

An analysis of what is currently known about the role of maternal folate and iron deficiencies in pregnancy wastage, including abruptio placentae, fetal malformation, and abortion, is presented. Several observations are described which are not compatible with the concept that maternal folate or iron deficiency, per se, is of significance in the genesis of perinatal mortality or serious morbidity. The fetus and placenta quite effectively parasitize folate and iron from the mother even when she is grossly deficient in these nutrients.

Maternal folate deficiency and pregnancy wastage

Abstract There is ample evidence that folate requirements are considerably increased during pregnancy and as the consequence some degree of folate deficiency is more apt to be found in pregnant than in nonpregnant women. When folate deficiency is of such intensity and duration as to cause maternal anemia, plasma folate levels are quite low, marrow cytomorphology is megaloblastic, and neutrophil nuclear hypersegmentation usually is apparent. These changes characteristic of maternal folate deficiency were neither more frequent nor more intense in women with placental abruption than in apparently healthy women during late pregnancy. Consequently these observations do not support the contention of some that placental abruption results from maternal folate deficiency.

Maternal folate deficiency and pregnancy wastage: I. Placental abruption☆☆☆

Abstract There is ample evidence that folate requirements are considerably increased during pregnancy and as the consequence some degree of folate deficiency is more apt to be found in pregnant than in nonpregnant women. When folate deficiency is of such intensity and duration as to cause maternal anemia, plasma folate levels are quite low, marrow cytomorphology is megaloblastic, and neutrophil nuclear hypersegmentation usually is apparent. These changes characteristic of maternal folate deficiency were neither more frequent nor more intense in women with placental abruption than in apparently healthy women during late pregnancy. Consequently these observations do not support the contention of some that placental abruption results from maternal folate deficiency.

Transactions of the Ninety-second Annual Meeting of the American Gynecological SocietyMaternal folate deficiency and pregnancy wastage: I. Placental abruption☆☆☆

Abstract There is ample evidence that folate requirements are considerably increased during pregnancy and as the consequence some degree of folate deficiency is more apt to be found in pregnant than in nonpregnant women. When folate deficiency is of such intensity and duration as to cause maternal anemia, plasma folate levels are quite low, marrow cytomorphology is megaloblastic, and neutrophil nuclear hypersegmentation usually is apparent. These changes characteristic of maternal folate deficiency were neither more frequent nor more intense in women with placental abruption than in apparently healthy women during late pregnancy. Consequently these observations do not support the contention of some that placental abruption results from maternal folate deficiency.