Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana.

Deficiencies of micronutrients (zinc, iron, folic acid and iodine) during pregnancy are known causes of Low Birth Weight (LBW). Studies have documented status of one or two micronutrients amongst pregnant women (PW). However, no attempt has been made to concurrently assess the prevalence of multiple micronutrient deficiencies and the factors associated with them amongst PW. OBJECTIVE: The present study was undertaken to assess the prevalence of multiple micronutrient deficiencies amongst PW in a rural area. METHODS: A community based cross sectional survey was conducted in six villages of a rural area of district Faridabad in Haryana state, India during November 2000 and October 2001. All PW aged 18 years or more, with pregnancy duration of more than 28 weeks were enrolled. Data were collected on socio-economic status and other demographic parameters. Serum zinc, copper and magnesium levels were estimated by utilizing the Atomic absorption spectrophotometry (AAS); serum ferritin and folate was estimated by Enzyme Linked Immuno Sorbent Assay (ELISA) method and the Radio-Immuno Assay (RIA) method, respectively and serum thyroid stimulating hormone (TSH) level was estimated by the Abbot AxSYM System. Serum zinc, copper, magnesium, ferritin, and folate levels less than 70.0 microg/dl, 80.0 microg/dl, 1.80 mg/dl, 15 ng/ml, and 3 ng/ml, respectively were considered as indicative of deficiency for respective micronutrients. The TSH levels of 4.670 and more indicated iodine deficiency status. Dietary intake of micronutrients was assessed utilizing 1-day 24-hour dietary recall methodology. Food consumption pattern was assessed utilizing the food frequency questionnaire methodology. RESULTS: Nearly 73.5, 2.7, 43.6, 73.4, 26.3, and 6.4 percent PW were deficient in zinc, copper, magnesium, iron, folic acid and iodine, respectively. The highest concurrent prevalence of two, three, four and five micronutrient deficiency was of zinc and iron (54.9%); zinc, magnesium and iron (25.6%); zinc, magnesium, iron and folic acid (9.3%) and zinc, magnesium, iron, folic acid and iodine (0.8%), respectively. No pregnant woman was found to have concomitant deficiencies of all the six micronutrients. Dietary intake data revealed an inadequate nutrient intake. Over 19% PW were consuming less than 50% of the recommended calories. Similarly, 99, 86.2, 75.4, 23.6, 3.9 percent of the PW were consuming less than 50% of the recommended folic acid, zinc, iron, copper, and magnesium. The consumption of food groups rich in micronutrients (pulses, vegetables, fruits, nuts and oil seeds, animal foods) was infrequent. Univariate and Multivariate logistic regression analysis revealed that low dietary intake of nutrients, low frequency of consumption of food groups rich in micronutrients and increased reproductive cycles with short interpregnancy intervals were important factors leading to micronutrient deficiencies. CONCLUSION: There was a high prevalence of micronutrient deficiencies amongst the PW of the area, possibly due to the poor dietary intake of food and low frequency of consumption of food groups rich in micronutrients. The concurrent prevalence of two, three, four and five micronutrient deficiencies were common.

Status of serum ferritin and folate levels amongst young women in a rural community of Haryana, India.

A community based cross sectional study was conducted amongst young married non-pregnant women aged 18 years or more from six randomly selected villages in Ballabhgarh block, district Faridabad, Haryana state. Data was collected on socio-demographic profile and obstetric parameters utilizing a pre-tested semi-structured questionnaire. The non-pregnancy status of the women was confirmed by inquiring about the last menstrual period. Serum ferritin and folate levels were assessed utilizing the ELISA and the RIA method, respectively Serum ferritin and folate levels less than 15.0 and 3 ng/ml were considered as indicator of poor iron and folic acid stores, respectively. The dietary intake of iron, folic acid and calories was assessed utilizing the 24-hour dietary recall methodology. Almost 63.8 and 27.7 % of the women had poor serum ferritin and folate levels. The mean dietary intake of iron, folic acid and calories was 14.8+/-7.7 mg, 49.2+/-20.1 microg, and 1564+/-411 kcal, respectively. There was an inadequate intake of food as revealed by their calorie intake that was 83.4% of the recommended dietary allowances. Only 6.9 and 7.8 % of the women were consuming iron and folic acid more than 75.0 % of the recommeded dietary allowances (RDA) Women with dietary intake of calories less than 50.0 % of the RDA had a lower serum ferritin level compared to the women who had a higher calorie intake. It was also revealed that there was a decreasing trend in serum folate levels with poor socio-economic status. Young rural women had poor serum ferritin and folate levels in the community studied, possibly due to poor dietary intake of food and thereby iron and folic acid. Distribution of iron and folic acid tablets may be recommended to young women of reproductive age group.