Micronutrient Status during Pregnancy and Effects of Antenatal Supplementation with Multiple Micronutrients versus Iron-folic Acid in Rural Bangladesh

Women often enter pregnancy with micronutrient deficiencies that are exacerbated by the demands of pregnancy. Yet micronutrient status of pregnant women is uncommonly assessed, even as momentum toward preventing multiple micronutrient (MM) deficiencies increases worldwide. In a substudy of a trial of MM versus iron‐folic acid (IFA) supplementation from first trimester (TM) through 3 mo postpartum in rural Bangladesh, we identified n=1526 women with plasma samples obtained in the 1st TM, prior to supplementation, and in the 3rd TM, in whom to evaluate micronutrient status. In available data (n=234‐1440 per nutrient assay), 6.8% of women were vitamin A deficient (retinol < 0.7 μmol/L), 41.7% had low β‐carotene (< 0.09 μmol/L), 57.7% were vitamin E (α‐tocopherol < 12 μmol/L) and 73.5% were vitamin D (25‐hydroxyvitamin D < 50 nmol/L) deficient. Folate deficiency (plasma folate < 6.8 nmol/L) was 2.6%, while vitamin B12 deficiency (cobalamin < 150 pmol/L) occurred in 29.8% of women. Anemia affected 20.6% of women, but iron deficiency by TfR (4.7% > 8.3 μg/mL) and ferritin (1.8% < 12 μg/L) was uncommon. Alpha‐1 acid glycoprotein > 1 g/L, indicating inflammation, was present in 8.1% of women. Baseline zinc and iodine status, and MM versus IFA effects on micronutrient status by the 3rd TM, will be presented. Vitamin deficiencies are common early in pregnancy in rural Bangladesh, representing preventable hidden hunger. Grant Funding Source : Supported by the Bill and Melinda Gates Foundation Grant #614