Assessment of Micronutrient Status in Pregnant Malawian Women Before and After Treatment for Moderate Malnutrition

Abstract

BackgroundMultiple micronutrient deficiencies are prevalent in pregnant women in developing countries, and can result in adverse effects to both the mother and infant.ObjectiveThe objective was to assess change in micronutrient and protein levels in moderately malnourished pregnant Malawian women after receiving one of three nutritional interventions.MethodsSerum retinol, 25‐hydroxyvitamin D, ferritin, vitamin B12, folate, zinc, albumin and C‐reactive protein concentrations were measured in pregnant women with MUAC >20.6 cm and <23.0 cm at baseline (n=343) and 10 weeks later (n=210) after receiving either: 1) macro‐ and micronutrient fortified, peanut‐based, ready‐to‐use supplementary food (RUSF), 2) corn‐soy blended flour with a prenatal multiple micronutrient supplement (CSB‐UNIMMAP), or 3) corn‐soy blended flour with iron and folic acid (CSB‐IFA). Each provides approximately double the RDA of selected nutrients and 900 kcal/day.ResultsBaseline micronutrient levels indicated high rates of deficiency in zinc (86.9%), albumin (39.9%), vitamin B12 (35.7%), vitamin D (36.1%), and marginal retinol status (47.0%). Preliminary results show the mean changes in folate from week 0 to week 10 were 2.22, 1.80, and 4.26 ng/mL for RUSF, CSB‐UNIMMAP, and CSB‐IFA respectively (p=0.002). Mean changes in vitamin D were 6.38, 3.18, and 2.18 ng/mL for RUSF, CSB‐UNIMMAP, and CSB‐IFA respectively (p=0.004). The rates of deficiency at week 10 for vitamin B12 were 34.7%, 44.0%, and 62.8% for RUSF, CSB‐UNIMMAP, and CSB‐IFA respectively (p=0.003). The other changes in micronutrients did not reach levels of significance.ConclusionsDeficiencies in zinc, vitamin D, vitamin B12 and albumin are common among moderately malnourished pregnant Malawian women. Preliminary data indicates significant changes in vitamin B12 deficiency and folate and vitamin D concentrations from week 0 to week 10, with the RUSF group having the greatest improvement for vitamin D and vitamin B12.Support or Funding InformationU.S. Dairy Export Council, Dairy Research Initiative, California State University Agricultural Research Institute‐ San Luis Obispo