Prevalence of anemia and micronutrient deficiencies in early pregnancy in rural Bangladesh, the MINIMat trial.

International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Sweden.
Acta Obstetricia Et Gynecologica Scandinavica (Impact Factor: 1.99). 01/2011; 90(1):47-56. DOI: 10.1111/j.1600-0412.2010.01014.x
Source: PubMed

ABSTRACT To describe the prevalence of anemia and micronutrient deficiencies as well as their determinants in early pregnancy.
Baseline data from a population-based randomized intervention trial.
The study was conducted in Matlab, a sub-district in rural Bangladesh from 1 January to 31 December 2002.
Pregnant women (n= 740) were enrolled in approximately week 14 in pregnancy.
Data were collected using questionnaires, physical examinations and laboratory analyses of blood samples for concentrations of hemoglobin, ferritin, zinc, folate and vitamin B-12.
Covariates associated with anemia and micronutrient deficiencies in bivariate analyses were evaluated in multivariate logistic regression models adjusting for potential confounders.
Anemia was present in 28% of the women, 55% were zinc deficient, 46% were vitamin B-12 deficient and 18% were folate deficient. Anemia was not associated with iron deficiency but rather with vitamin B-12 deficiency. Infestation with Ascaris was highly prevalent (67%) and associated with both folate and vitamin B-12 deficiency. Anemia and micronutrient deficiencies all varied significantly with season.
The high prevalences of zinc and vitamin B-12 deficiencies in early pregnancy are a concern, as it could lead to adverse pregnancy outcomes and increased health risks for both mother and child. The prevalence of iron deficiency was low, but as this was during early pregnancy, the women might develop iron deficiency and consequently iron deficiency anemia as the pregnancy progresses.

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    ABSTRACT: Background: Betel nut (BN) or areca nut (AN) chewing habits on its own or with other ingredients including chewing tobacco are highly prevalent in many South East Asian countries as well as among the migrants from these countries residing around the world. The major alkaloid arecoline in the BN has been found to carcinogenic and to be associated with a range of health risks, including negative effects on pregnancy outcomes. Pregnancy imposes stress on folate stores because of increased requirements for growth of maternal tissues, fetus, and placenta. Folate deficiency during pregnancy is a major public health concern as is associated with many adverse health outcomes including neural tube defects, low birth weight, preterm birth, and delayed maturation of the nervous system, growth retardation, and megaloblastic anemia. Objective: To investigate any association between BN consumption and folate status among pregnant women in rural Bangladesh. Materials and Methods: Data of 730 pregnant women aged 14-50 years from the Maternal and Infant Nutrition Intervention in Matlab (MINIMat) trial in Bangladesh were included in this study. Logistic regression analysis and analyses of covariance (ANCOVA) were used. Results were adjusted for potential confounders. Results and Interpretation: Two-third (63%) of the women consumed BN and 17% had folate deficiency. The women who consumed BN combined with chewing tobacco were 2.57 times more likely to have folate deficiency (OR = 2.57; 95% CI = 1.23-5.36; P = 0.012;) and the women who consumed BN 2-3 times/day were 2.51 times more likely to develop folate deficiency among users (OR = 2.51; 95% CI = 1.07-5.92; P = 0.035). Mean serum folate levels were significantly lower among BN users as compared to nonusers. Conclusion: The results suggest that betel nut consumption combined with chewing tobacco is associated with lower serum folate level and folate deficiency among pregnant women in rural Bangladesh. Strategies are needed for prevention and control of betel nut consumption in order to prevent adverse health outcomes.
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