title: Folacin, cobalamin, and hematological status during pregnancy in rural Kenya: the influence of parity, gestation, and Plasmodium falciparum malaria.
abstract: To investigate folacin concentrations in malaria during pregnancy, women attending a rural antenatal clinic in Kenya were studied. Low serum folacin values had poor specificity for low red blood cell (RBC) folacin concentrations. Multigravidae had lower mean serum folacin (p less than 0.03) and RBC folacin (p less than 0.001) values than primigravidae. Primigravidae had higher mean RBC folacin values than nulliparae (p less than 0.05). Although anemia was frequent, no evidence of neutrophil hypersegmentation was seen in blood smears of individuals with low RBC folacin or indeterminate cobalamin values. The unexpectedly high RBC folacin concentrations are probably related to P falciparum infection: during followup a significant decrease in both RBC and serum folacin activity occurred after chloroquine was administered. This decrease may be unrelated to a gestational effect (RBC folacin p less than 0.01; serum folacin p less than 0.025). The pathogenesis of high RBC folacin activity is discussed in relation to reticulocytosis as well as to a biochemical mechanism within the RBC.
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology; D004906:Erythrocyte Count; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D005492:Folic Acid / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D007630:Kenya; D008288:Malaria / Q000097:blood* / Q000453:epidemiology; D010298:Parity; D010963:Plasmodium falciparum; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011863:Radioimmunoassay; D012423:Rural Health; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D005492:Folic Acid; D014805:Vitamin B 12