Nutritional factors associated with anaemia in pregnant women in northern Nigeria

Dorothy J Vanderjagt, Hugh S Brock, George S Melah, Aliyu U El-Nafaty, Michael J Crossey, Robert H Glew, Dorothy J Vanderjagt, Hugh S Brock, George S Melah, Aliyu U El-Nafaty, Michael J Crossey, Robert H Glew

Abstract

This study was conducted to assess the relative contribution of iron, folate, and B 12 deficiency to anaemia in pregnant women in sub-Saharan Africa. In total, 146 pregnant women, who attended two antenatal clinics in Gombe, Nigeria, were recruited into the study. The majority (54%) of the women were in the third trimester. Blood samples were obtained for determination of haematocrit and for measurement of serum iron, total iron-binding capacity, ferritin, folate, vitamin B12, and homocysteine. Malaria was present in 15 (9.4%) women. Based on a haemoglobin value of<105 g/L, 44 (30%) women were classified as anaemic. The major contributing factor to anaemia was iron deficiency based on the serum concentration of ferritin (<10 ng/mL). The mean homocysteine concentration for all subjects was 14.1 pmol/L, and homocysteine concentrations were inversely correlated with concentrations of folate and vitamin B 12. The serum homocysteine increased markedly at serum vitamin B12 levels below 250 pmol/L. The most common cause of anaemia in the pregnant women in northern Nigeria was iron deficiency, and the elevated concentrations of homocysteine were most likely due to both their marginal folate and vitamin B12 status.

Figures

Fig. 1.
Fig. 1.
Relationship between serum concentrations of homocysteine and serum concentrations of folate in pregnant women in northern Nigeria (r=0.24, p=0.003)
Fig. 2.
Fig. 2.
Relationship between serum concentrations of homocysteine and serum concentrations of vitamin B12 in pregnant women in northern Nigeria (r=0.41, p

References

    1. World Health Organization . The prevalence of anaemia in women: a tabulation of available information. Geneva: Maternal Health and Safe Motherhood Programme, World Health Organization; 1992. p. 100.
    1. Brabin BJ, Hakimi M, Pelletier D. An analysis of anemia and pregnancy-related maternal mortality. J Nutr. 2001;131:604S–15.
    1. van den Broek N. Anaemia in pregnancy in developing countries. Br J Obstet Gynaecol. 1998;105:385–90.
    1. World Health Organization . Prevention and management of severe anaemia in pregnancy: report of a technical working group. Geneva: World Health Organization; 1994. pp. 20–22. May 1991. 35 p. (WHL/ FHE/MSM/93.3).
    1. World Bank . World development report 1993: investing in health. Washington, DC: World Bank; 1993. p. 329.
    1. Ujah IAO, Uguru UE, Aisien AO, Sagay AS, Otubu JAM. How safe is motherhood in Nigeria?: trends of maternal mortality in a tertiary health institution. East Afr Med J. 1999;76:436–9.
    1. Onwuhafua PI, Onwuhafua A, Adze J. The challenge of reducing maternal mortality in Nigeria. Int J Gynaecol Obstet. 2000;71:211–3.
    1. Adamu YM, Salihu HM, Sathiakumar N, Alexander GR. Maternal mortality in Northern Nigeria: a population-based study. Eur J Obstet Gynecol Reprod Biol. 2003;109:153–9.
    1. Baker SJ, DeMaeyer EM. Nutritional anemia: its understanding and control with special reference to the work of the World Health Organization. Am J Clin Nutr. 1979;32:368–417.
    1. DeMaeyer E, Adiels-Tegman M. The prevalence of anaemia in the world. World Health Stat Q. 1985;38:302–16.
    1. Fleming AF. A study of anaemia in pregnancy in Ibadan, Western Nigeria, with special reference to folic acid deficiency. Cambridge: Cambridge University; 1968. (MD thesis).
    1. VanderJagt DJ, Spelman K, Ambe J, Datta P, Blackwell W, Crossey M, et al. Folate and vitamin B12 status of adolescent girls in northern Nigeria. J Natl Med Assoc. 2000;92:334–40.
    1. Burtis CA, Ashwood ER, editors. Tietz Fundamentals of clinical chemistry, 5th ed. Philadelphia: Saunders; 2001. p. 1,091.
    1. van den Broek NR, Letsky EA, White SA, Shenkin A. Iron status in pregnant women: which measurements are valid? Br J Haematol. 1998;103:817–24.
    1. van den Broek NR, Letsky EA. Etiology of anemia in pregnancy in south Malawi. Am J Clin Nutr. 2000;72:247S–56S.
    1. Lindenbaum J, Rosenberg IH, Wilson PW, Stabler SP, Allen RH. Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr. 1994;60:2–11.
    1. Vollset SE, Refsum H, Irgens LM, Emblem BM, Tverdal A, Gjessing HK, et al. Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine study. Am J Clin Nutr. 2000;71:962–8.
    1. Refsum H. Folate, vitamin B12 and homocysteine in relation to birth defects and pregnancy outcome. Br J Nutr. 2001;85 (Suppl 2):S109–13.
    1. Glew RH, Williams M, Conn CA, Cadena SM, Crossey M, Okolo SN, et al. Cardiovascular disease risk factors and diet of Fulani pastoralists of northern Nigeria. Am J Clin Nutr. 2001;74:730–6.
    1. Glew RH, Conn CA, VanderJagt TA, Calvin CD, Obadofin MO, Crossey MJ, et al. Risk factors for cardiovascular disease and diet of urban and rural dwellers in northern Nigeria. J Health Popul Nutr. 2004;22:357–69.
    1. VanderJagt DJ, Patel RJ, El-Nafaty AU, Melah GS, Crossey MJ, Glew RH. High-density lipoprotein and homocysteine levels correlate inversely in preeclamptic women in northern Nigeria. Acta Obstet Gynecol Scand. 2004;83:536–42.
    1. Chanarin I, Deacon R, Perry J, Lumb M. How vitamin B12 acts. Br J Haematol. 1981;47:487–91.
    1. Egwunyenga AO, Ajayi JA, Nmorsi OP, Duhlinska-Popova DD. Plasmodium/intestinal helminth co-infections among pregnant Nigerian women. Mem Inst Oswaldo Cruz. 2001;96:1055–9.

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