Abstract
Anemia and micronutrient (MN) deficiencies in pregnant women are associated with adverse pregnancy outcomes. In Niger, 58.6% of pregnant women are anemic; however, MN statuses are unknown. The study objectives were to estimate the prevalence of MN deficiencies among pregnant women in Zinder, Niger and explore associated risk factors. Pregnant women living in randomly selected rural villages (n = 88) were included. Capillary and venous blood samples (n = 770) were analyzed for hemoglobin (Hb) and plasma ferritin, soluble transferrin receptor (sTfR), zinc (pZn), retinol binding protein (RBP), folate and vitamin B12. C-reactive protein and alpha-1-acid glycoprotein were measured to adjust for inflammation. The prevalence of MN deficiencies in pregnant woman was high, indicative of a severe public health problem. Prevalence of iron deficiency was 20.7% and 35.7%, by ferritin (<15 µg/L) and sTfR (>8.3 mg/L), respectively. In total, 40.7% of women had low pZn (<50 µg/dL), 79.7% had marginal RBP (<1.32 µmol/L), 44.3% of women had low folate (<10 nmol/L) and 34.8% had low B12 concentrations (<148 pmol/L). Common risk factors associated with MN status included gravidity, mid-upper-arm circumference, geophagy, malaria, and result of the woman’s last pregnancy. Interventions to promote the strengthening of antenatal care, and access and adherence to nutrition and health interventions are critical among pregnant women in this population.
Highlights
Micronutrient (MN) deficiencies in pregnancy are associated with adverse health outcomes for both the pregnant woman and her offspring, including maternal anemia, maternal and perinatal mortality, and low birth weight, pre-term birth, intra-uterine growth restriction, altered immune response and cognitive deficits in the newborn [1,2,3,4,5,6,7].Physiological MN requirements increase during pregnancy to meet increased maternal metabolic demands, increased erythropoiesis, accretion of maternal tissue reserves and fetal requirements for growth and development
The present study identified a high prevalence of anemia and multiple micronutrient deficiencies among pregnant women in rural villages in the Zinder Region of Niger, which indicates the need for immediate strengthening and expansion of existing programs targeting pregnant women, including
The recent World Health Organization (WHO) Recommendations on Antenatal Care do not support the global use of Multiple micronutrient (MMN) supplements in pregnancy, the prevalence of MMN deficiencies in the present study population is of severe public health concern, and policymakers should consider that the benefits of MMN
Summary
Micronutrient (MN) deficiencies in pregnancy are associated with adverse health outcomes for both the pregnant woman and her offspring, including maternal anemia, maternal and perinatal mortality, and low birth weight, pre-term birth, intra-uterine growth restriction, altered immune response and cognitive deficits in the newborn [1,2,3,4,5,6,7].Physiological MN requirements increase during pregnancy to meet increased maternal metabolic demands, increased erythropoiesis, accretion of maternal tissue reserves and fetal requirements for growth and development. Micronutrient (MN) deficiencies in pregnancy are associated with adverse health outcomes for both the pregnant woman and her offspring, including maternal anemia, maternal and perinatal mortality, and low birth weight, pre-term birth, intra-uterine growth restriction, altered immune response and cognitive deficits in the newborn [1,2,3,4,5,6,7]. Women in low-income countries are vulnerable to MN deficiencies during pregnancy, owing to beginning pregnancy with MN deficiencies or depleted stores, inadequate dietary intakes during pregnancy (e.g., limited access to and consumption of foods rich in micronutrients and poor absorption), frequent exposure to infection, initiation of pregnancy during adolescence, high fertility rates and short inter-pregnancy intervals [4,8]. MN deficiencies among pregnant women in Niger are believed to be a serious problem, but there is only limited information available on women’s nutritional status during pregnancy. The proportion of pregnant women with night blindness was previously estimated at 6.6% [12] and 15.5% of women of child-bearing age are undernourished (BMI < 18.5 kg/m2 ) [9]
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