In pregnancy, microcytic anemia is most likely to be which diagnosis?

• A. Anemia of chronic disease
• B. Megaloblastic anemia
• C. Aplastic anemia
• D. Iron deficiency anemia

Answer: (D)

In pregnancy, iron needs rise sharply because blood volume increases and the fetus also requires iron. When those needs outpace iron intake and stores, iron-deficiency anemia develops and red blood cells become smaller and paler, producing microcytosis. That makes iron deficiency the most likely cause of microcytic anemia in a pregnant patient.

Anemia of chronic disease tends to occur with ongoing inflammation or illness and is usually normocytic or mildly microcytic rather than clearly microcytic; megaloblastic anemia causes macrocytosis due to B12 or folate deficiency; aplastic anemia presents with pancytopenia and a hypocellular marrow.