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: 2.43).
01/2011; 90(1):47-56. DOI: 10.1111/j.1600-0412.2010.01014.x
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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Available from: Saeed Akhtar
- "Zinc supplementation resulted in 15% less incidence of diarrhoea, thus saving the lives of 30,000-75,000 children per year. A reduction of 15% in the illness duration and 16% reduction in the likelihood of disease progression were observed as a positive effect of zinc supplementation in Bangladesh (40,41). "
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ABSTRACT: This article attempts to highlight the gravity of prevalence of zinc deficiency and its health and economic consequences in South Asian developing countries and to shed light on possible approaches to combat zinc deficiency. A computer-based search was performed on PubMed, Google, and Science Direct.com to retrieve relevant scientific literature published between 2000 and 2012; the search yielded 194 articles, of which 71 were culled. Studies were further screened on the basis of population groups, age and sex, pregnancy, and lactation. The most relevant articles were included in the review. Cutoffs for serum zinc concentration defined for zinc deficiency were 65 µg/dL for males and females aged <10 years, 66 µg/dL for non-pregnant females, and 70 µg/dL for males aged ≥10 years. Population segments from rural and urban areas of South Asian developing countries were included in the analysis. They comprised pregnant and lactating women, preschool and school children. The analysis reveals that zinc deficiency is high among children, pregnant and lactating women in India, Pakistan, Bangladesh, Sri Lanka, and Nepal. Diarrhea has been established as a leading cause to intensify zinc deficiency in Bangladesh. Little has been done in Sri Lanka and Nepal to estimate prevalence of zinc deficiency precisely. A substantial population segment of the South Asian developing countries is predisposed to zinc deficiency which is further provoked by increased requirements for zinc under certain physiological conditions. Supplementation, fortification, and dietary diversification are the most viable strategies to enhancing zinc status among various population groups
Journal of Health Population and Nutrition 06/2013; 31(2). DOI:10.3329/jhpn.v31i2.16378 · 1.04 Impact Factor
Available from: Kathleen M Rasmussen
- "Growth retardation is one potential consequence of anemia in children, and improving iron and zinc status in undernourished children aged 1–4 years improves growth trajectories (53). Both arsenic and cadmium were inversely associated with family SES, a broad indicator of nutritional status (54), and the associations of both markers with anthropometric outcomes were attenuated by the addition of SES and other potential confounders to the model. However, we observed that the inverse association between arsenic exposure and children's growth was apparent only among children of the highest SES, and that the inverse association between cadmium exposure and children's growth was mildly attenuated among children of the highest SES compared with children of the lowest SES. "
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ABSTRACT: In this prospective cohort study, based on 1,505 mother-infant pairs in rural Bangladesh, we evaluated the associations between early-life exposure to arsenic, cadmium, and lead, assessed via concentrations in maternal and child urine, and children's weights and heights up to age 5 years, during the period 2001-2009. Concurrent and prenatal exposures were evaluated using linear regression analysis, while longitudinal exposure was assessed using mixed-effects linear regression. An inverse association was found between children's weight and height, age-adjusted z scores, and growth velocity at age 5 years and concurrent exposure to cadmium and arsenic. In the longitudinal analysis, multivariable-adjusted attributable differences in children's weight at age 5 years were -0.33 kg (95% confidence interval (CI): -0.60, -0.06) for high (≥95th percentile) arsenic exposure and -0.57 kg (95% CI: -0.88, -0.26) for high cadmium exposure, in comparison with children with the lowest exposure (≤5th percentile). Multivariable-adjusted attributable differences in height were -0.50 cm (95% CI: -1.20, 0.21) for high arsenic exposure and -1.6 cm (95% CI: -2.4, -0.77) for high cadmium exposure. The associations were apparent primarily among girls. The negative effects on children's growth at age 5 years attributable to arsenic and cadmium were of similar magnitude to the difference between girls and boys in terms of weight (-0.67 kg, 95% CI: -0.82, -0.53) and height (-1.3 cm, 95% CI: -1.7, -0.89).
American journal of epidemiology 05/2013; 177(12). DOI:10.1093/aje/kws437 · 5.23 Impact Factor
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ABSTRACT: Women of reproductive age are at a high risk of iron deficiency, often as a result of diets low in bioavailable iron. In some settings, the iron content of domestic groundwater sources is high, yet its contribution to iron intake and status has not been examined. In a rural Bangladeshi population of women deficient in dietary iron, we evaluated the association between groundwater iron intake and iron status. In 2008, participants (n = 209 with complete data) were visited to collect data on 7-d food frequency, 7-d morbidity history, 24-h drinking water intake, and rice preparation, and to measure the groundwater iron concentration. Blood was collected to assess iron and infection status. Plasma ferritin (μg/L) and body iron (mg/kg) concentrations were [median (IQR)] 67 (46, 99) and 10.4 ± 2.6, respectively, and the prevalence of iron deficiency (ferritin < 12 μg/L) was 0%. Daily iron intake from water [42 mg (18, 71)] was positively correlated with plasma ferritin (r = 0.36) and total body iron (r = 0.35) (P < 0.001 for both). In adjusted linear regression analyses, plasma ferritin increased by 6.1% (95% CI: 3.8, 8.4%) and body iron by 0.3 mg/kg (0.2, 0.4) for every 10-mg increase in iron intake from water (P < 0.001). In this rural area of northern Bangladesh, women of reproductive age had no iron deficiency likely attributable to iron consumed from drinking groundwater, which contributed substantially to dietary intake. These findings suggest that iron intake from water should be included in dietary assessments in such settings.
Journal of Nutrition 03/2011; 141(5):944-9. DOI:10.3945/jn.111.138628 · 3.88 Impact Factor
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