Anemia and Vitamin B-12 and Folate Status in Women of Reproductive Age in Southern India: Estimating Population-Based Risk of Neural Tube Defects

被引：21

作者：

Finkelstein, Julia L. ^{[1
,2
]}

Fothergill, Amy ^{[1
]}

Johnson, Christina B. ^{[3
]}

Guetterman, Heather M. ^{[1
]}

Bose, Beena ^{[2
]}

Jabbar, Shameem ^{[4
]}

Zhang, Mindy ^{[4
]}

Pfeiffer, Christine M. ^{[4
]}

Qi, Yan Ping ^{[5
]}

Rose, Charles E. ^{[5
]}

Williams, Jennifer L. ^{[5
]}

Bonam, Wesley ^{[3
]}

Crider, Krista S. ^{[5
]}

机构：

[1] Cornell Univ, Div Nutr Sci, Ithaca, NY 14853 USA

[2] St Johns Res Inst, Bangalore, Karnataka, India

[3] Arogyavaram Med Ctr, Chittoor, Andhra Pradesh, India

[4] Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA USA

[5] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA

来源：

CURRENT DEVELOPMENTS IN NUTRITION | 2021年 / 5卷 / 05期

基金：

美国国家卫生研究院;

关键词：

anemia; folate; vitamin B-12; NTDs; periconceptional; surveillance; India; FOLIC-ACID FORTIFICATION; CHILDBEARING-AGE; NONPREGNANT WOMEN; BIRTH PREVALENCE; MATERNAL ANEMIA; GLOBAL BURDEN; UNITED-STATES; PREVENTION; PREGNANCY; DEFICIENCY;

D O I：

10.1093/cdn/nzab069

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Background: Women of reproductive age (WRA) are a high-risk population for anemia and micronutrient deficiencies. However, there are few representative population-level data from India, which could help inform evidence-based recommendations and policy. Objective: To conduct a population-based biomarker survey of anemia and vitamin B-12 and folate status in WRA as part of a periconceptional surveillance program in southern India. Methods: Participants were WRA (15-40 y) who were not pregnant or lactating. Whole blood (n = 979) was analyzed for hemoglobin via a Coulter counter (Coulter HMX). Plasma, serum, and RBCs were processed and stored at -80`C or less until batch analysis. Vitamin B-12 concentrations were measured via chemiluminescence; RBC and serum folate concentrations were evaluated via microbiological assay. Anemia and severe anemia were defined as hemoglobin <12.0 g/dL and <8.0 g/dL, respectively. Vitamin B-12 deficiency and insufficiency were defined as total vitamin B-12 <148 pmol/L and <221 pmol/L, respectively. Folate deficiency and insufficiency were defined as RBC folate <305 nmol/L and <748 nmol/L. A previously developed Bayesian model was used to predict neural tube defect (NTD) prevalence per 10,000 births. Results: A total of 41.5% of WRA had anemia and 3.0% had severe anemia. A total of 48.3% of WRA had vitamin B-12 deficiency and 74.3% had vitamin B-12 insufficiency. The prevalence of RBC folate deficiency was 7.6%, and 79.3% of WRA had RBC folate <748 nmol/L, the threshold for optimal NTD prevention. Predicted NTD prevalence per 10,000 births based on RBC folate concentrations was 20.6 (95% uncertainty interval: 16.5-25.5). Conclusions: The substantial burden of anemia, vitamin B-12 deficiency, and RBC folate insufficiency in WRA in this setting suggests an opportunity for anemia and birth defects prevention. Findings will directly inform the development of a randomized trial for anemia and birth defects prevention in southern India.

引用

页数：15