Pancytopenia in the Third Trimester of Pregnancy: A Case of Concurrent Folate and Zinc Deficiencies due to Unbalanced Dietary Habits

A 25-year-old pregnant woman (gravida 2, para 1) presented with progressive anemia unresponsive to iron supplementation, ultimately developing pancytopenia at 37 weeks of gestation. Despite adequate caloric intake, her diet consisted primarily of ultra-processed and frozen foods. Laboratory findings showed hemoglobin of 5.5 g/dL, mean corpuscular volume of 102.9 fL, and elevated lactate dehydrogenase. Her serum folate, vitamin B₁₂, and zinc levels were 1.3 ng/mL, 131 pg/mL, and 57 μg/dL, respectively. A healthy infant was delivered via cesarean section at 38 weeks, and the mother's pancytopenia improved with supplementation. To our knowledge, few reports have described concurrent folate- and zinc-deficiency-associated pancytopenia during pregnancy without significant weight loss or overt dietary restriction, particularly in the context of a diet high in ultra-processed foods but with sufficient caloric intake. This case highlights the risks of poor micronutrient intake despite adequate macronutrient consumption and underscores the importance of nutritional monitoring during pregnancy.