Blood Journal
Leading the way in experimental and clinical research in hematology

Nutritional Deficiency and Anemia in Latin America: A Collaborative Study

  1. J. D. COOK, M.D.,
  2. J. ALVARADO, M.D.,
  3. A. GUTNISKY, M.D.,
  4. M. JAMRA, M.D.,
  5. J. LABARDINI, M.D.,
  6. M. LAYRISSE, M.D.,
  7. J. LINARES, M.D.,
  8. A. LORíA, PH.D.,
  9. V. MASPES, M.D.,
  10. A. RESTREPO, M.D.,
  11. C. REYNAFARJE, M.D.,
  12. L. SÁNCHEZ-MEDAL, M.D.,
  13. H. VÉLEZ, M.D., and
  14. F. VITERI, M.D.
  1. Division of Hematology, Department of Medicine, University of Washington, Seattle, Wash.; the Division of Biomedicine, Nutrition Institute of Central America and Panama, Guatemala City, Guatelmala; the Department of Physiology, Faculty of Medicine, the Northeastern University, Corrientes, Argentina; the Division of Hematology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil; the Department of Hematology, National Institute of Nutrition, Mexico City, Mexico; the Division of Hematology, Venezuelan Institute of Scientific Investigations, Caracas, Venezuela; the Nutrition Section, Faculty of Medicine, University of Antioquia, Medellin, Colombia; and the Institute of Biology of the Andes, Major National University of San Marcos, and the University of Vellarreal, Lima, Peru.
  2. Division of Hematology, Department of Medicine, University of Washington, Seattle, Wash.
  3. Division of Biomedicine, Nutrition Institute of Central America and Panama, Guatemala City, Guatemala.
  4. Department of Physiology, Faculty of Medicine, time Northeastern University, Corrientes, Argentina.
  5. Division of Hematology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
  6. Department of Hematology, National Institute of Nutrition, Mexico City, Mexico.
  7. Division of Hematology, Venezuelan Institute of Scientific Investigations, Caracas, Venezuela.
  8. Division of Hematology, Venezuelan Institute of Scientific Investigations, Caracas, Venezuela.
  9. Department of Hematology, National Institute of Nutrition, Mexico City, Mexico.
  10. Division of Hematology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
  11. Nutrition Section, Faculty of Medicine, University, of Antioquia, Medellin, Colombia.
  12. Institute of Biology of the Andes, Major National University of San Marcos, and University of Vellarreal, Lima, Peru.
  13. Department of Hematology, National Institute of Nutrition, Mexico City, Mexico.
  14. Nutrition Section, Faculty of Medicine, University of Antioquia, Medellin, Colombia.
  15. Division of Biomedicine, Nutrition Institute of Central America and Panama, Guatemala City, Guatemala.

Abstract

A collaborative study of nutritional anemia in third trimester pregnancy was performed in seven Latin American countries. Laboratory measurements included hemoglobin level, mean corpuscular hemoglobin concentration (MCHC), serum iron and iron-binding capacity, serum folate, vitamin B12 and albumin. Iron deficiency (transferrin saturation below 15%) was found in 48% of pregnant women, as compared with 21% of nonpregnant females and 3% of male controls of comparable age. The prevalence of folate deficiency (serum folate below 3 ng/ml.) was 10%, 10% and 9% in these three groups, respectively. Vitamin B12 deficiency (serum level below 80 pg/ml.) was found in 15% of pregnant women, but in less than 1% of both control groups. Anemia, as defined by current WHO criteria, was found in 38.5% of pregnant women, 17.3% of nonpregnant women and 3.9% of men. Analysis of the frequency distribution for hemoglobin levels, based on a Gaussian distribution in normal subjects, suggested that a large portion of subjects considered anemic by WHO criteria were normal and that the true incidence of anemia in pregnant and nonpregnant females was 22 and 12% respectively. Correlation analysis indicated that iron deficiency was of major importance as a cause of anemia, while folate lack was contributory only in pregnancy; no relationship could be demonstrated between vitamin B12 deficiency and anemia.

  • Submitted December 9, 1970.
  • Revision received June 7, 1971.
  • Accepted June 15, 1971.