Prevalence and Risk Factors for Micronutrient Deficiencies During Pregnancy in Cayenne, French Guiana (CarMa)

Prevalence of Micro-nutritional Deficiencies in Pregnant Women Presenting to the Emergency Department for Threatened Delivery

Micronutrient deficiencies are frequent in pregnant women in French Guiana, a French territory in South America. Micronutrient deficiencies are more frequent in precarious women. Obesity is a frequent problem but it is also associated with micronutrient deficiency. Micronutrient deficiencies have largely been overlooked in this outermost European region and should be corrected.

Study Overview

• Status: Completed
• Conditions: Pregnancy; Deficiency; Diet
• Intervention / Treatment: Other: Observational only

Detailed Description

Involved in physical and brain development, immunity and metabolism, micronutrients have profound health effects. The nutritional status of pregnant women is a major determinant of fetal health. French Guiana has a rapid population growth. Social inequalities, cultural practices and gastrointestinal nematode infections in French Guiana could affect the prevalence of these deficiencies. The main objective of the present study was to estimate the prevalence of micronutrient deficiency among pregnant women in French Guiana. The secondary objective was to identify socio-demographic, dietary, obstetrical and neonatal risk factors associated with deficiencies.

Pregnant women over 22 weeks of pregnancy hospitalized for delivery at the Obstetrical Emergency Department of the Hospital Center in Cayenne from May 2018 to March 2019 were included. A socio-demographic and food questionnaire was administered. Medical data were collected from the medical records. Blood and urine samples were taken. The descriptive analysis used Student and Chi2 tests.

A total of 341 women were included. The majority were born in Haiti (39%) and French Guiana (34%). At least one micronutrient deficiency was observed in 81% of women. Precarious women had a significantly greater risk of micronutrient deficiency during pregnancy compared to those with both normal and complementary health insurance.

Micronutrient deficiencies in pregnant women in French Guiana are a public health problem, a fact that was previously overlooked in a context of rising obesity. With over half of women overweight or obese and 81% with at least 1 micronutrient deficiency, balanced nutrition should be a major focus.

• Study Type: Observational
• Enrollment (Actual): 341

Contacts and Locations

Study Locations

• French Guiana
  • Cayenne, French Guiana, 97306
    • General Hospital of Cayenne

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

• Sampling Method: Probability Sample

Study Population

Any woman who was pregnant (22 weeks and more), hospitalized for delivery in the Gynecological and Obstetrical Emergency Unit at Cayenne hospital could participate in the studyafter giving written informed consent.The mode of delivery or urgent/non-urgent context did not influence the eligibility for inclusion. The criteria for non-inclusion were refusal to participate in the study; being under guardianship; and having already been enrolled in the study.

Description

Inclusion Criteria:

• Pregnant at least 22 weeks of amenorrhea (WHO threshold for fetal viability)
• Patient hospitalized for delivery in the Gynecological and Obstetrical Emergency Unit at Cayenne hospital
• Patient's consent
• Consent of the legal representative if the patient is a minor

Exclusion Criteria:

• Refusalto participate in the study.
• Being under guardianship or curatorship
• Having been previously enrolled in the study

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Cross-Sectional

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Identification of a micronutrient deficiency defined as at least one micronutrient below the lower limit.	urinary iodine < 100 µg/L; blood zinc level < 70 µg/dL; magnesium < 0.75 mmol/L; serum retinol < 0.70 µmol/L; erythrocyte folate < 305 nmol/L; blood cobalamin level < 150 pmol/L; Martial status: ferritin < 20 µg/L; serum iron < 15 µg/L; iron saturation coefficient of transferrin < 16%.	1 day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sociodemographic information	Socio-demographic and dietary risk factors associated with micronutrient deficiencies were investigated using a structured questionnaire.	1 day
assessment of Food diversity score	The food diversity score was inspired by the Food and Agriculture Organization's reports was assessed through a 24h recall, and calculated by adding the number of unique food groups consumed during last 24 hours.	1 day
Obstetrical and neonatal outcomes	Obstetrical and neonatal pathologies associated with micronutrient deficiencies were studied throughpatient interrogation and by analyzing medical records: rate of preeclampsia	1 day
Newborn health status	Gestational age at delivery, mode of delivery, weight, height, height, head circumference, APGAR, pathologies diagnosed on clinical examination before the 8th day of life	1 day
Mother Health status	Weight before pregnancy and on the day of inclusion, height, gestational age, pregnancy follow-up, microcytic anemia (hemoglobinemia <110 g/L, GMV >80 fl), primary hypothyroidism (increased TSH), gynaecological-obstetrical history, personal history of goiter or dysthyroidism, history of night blindness, personal history of anemia, other chronic conditions, history of digestive disorder/parasitoses, malaria history, drug treatment before and during pregnancy, micronutrient supplementation before and during pregnancy, tobacco use during pregnancy, alcohol use during pregnancy	1 day

Collaborators and Investigators

• Sponsor: Centre Hospitalier de Cayenne

Publications and helpful links

General Publications

• Duclau A, Abad F, Adenis A, Sabbah N, Leneuve M, Nacher M. Prevalence and risk factors for micronutrient deficiencies during pregnancy in Cayenne, French Guiana. Food Nutr Res. 2021 Feb 22;65. doi: 10.29219/fnr.v65.5268. eCollection 2021.

Study record dates

Study Major Dates

• Study Start (Actual): May 28, 2018
• Primary Completion (Actual): May 29, 2018
• Study Completion (Actual): March 31, 2019

Study Registration Dates

• First Submitted: July 6, 2021
• First Submitted That Met QC Criteria: August 24, 2021
• First Posted (Actual): August 26, 2021

Study Record Updates

• Last Update Posted (Actual): August 26, 2021
• Last Update Submitted That Met QC Criteria: August 24, 2021
• Last Verified: August 1, 2021

More Information

Terms related to this study

• Keywords: micronutrients; risks factors; social inequalities
• Additional Relevant MeSH Terms: Nutrition Disorders; Malnutrition
• Other Study ID Numbers: CARMA

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No