Iron and folate intake during pregnancy and its relationship with maternal biochemical indicators

Abstract

Introduction: Anemia during pregnancy is a public health problem in Latin America, including Colombia.

Objective: To evaluate the biochemical indicators of iron and folate nutritional state in a group of pregnant women belonging to a nutritional government program in Antioquia (Colombia).

Materials and methods: Quasi-experimental study of 26 poor pregnant women, who were beneficiaries of a program that included nutritional education, food complement fortified with micronutrients and supplements of iron, folic acid and vitamin C. Dietetic ingestion was evaluated by 24 hours reminders; the following parameters were measured: seric ferritin, hemoglobin, mean corpuscular volume,  C reactive protein, and seric folate. A stool specimen was examined for parasites. Pearson test was applied to correlate folate ingestion with seric folate concentration; Spearman test was used to correlate iron ingestion and seric ferritin; ANOVA of repeated measurements was employed for comparison betweenpregnancy trimesters; simple and multiple regression analyses were used to establish dependency of ferritin, hemoglobin and serum folate on the variables of interest. P < 0.05 was considered as significant.

Results: Anemia was prevented in 84.6%. The variable that better explained hemoglobin change during the third trimester was its value in the second trimester. Microcytosis diminished (p = 0.02) but women with the lesser iron ingestion had the highest prevalence during the third trimester (p = 0.009). Iron deficiency increased during pregnancy (p < 0.001) and a positive correlation was found between iron ingestion and ferritin concentration during the third trimester (r = 0.64; p < 0.001). Seric folate concentration increased during the second and third trimesters (p = 0.018), and a trend was observed toward positive correlation with folate ingestion, which was significant in the third trimester (r = 0.40, p = 0.044).

Conclusion: Nutritional supplements showed a positive effect on biochemical indicators, but they did not achieve an improvement of iron reserves. The importance of nutritional supplements during pregnancy is emphasized.