Jiang Tianan, Christian Parul, Khatry Subarna K, Wu Lee, West Keith P
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
J Nutr. 2005 May;135(5):1106-12. doi: 10.1093/jn/135.5.1106.
Pregnant women in developing countries are vulnerable to multiple micronutrient deficiencies. We investigated their prevalence and seasonal variation as part of a baseline assessment in a population-based, maternal micronutrient supplementation trial conducted in the rural Southeastern plains of Nepal. Serum concentrations of 11 micronutrients were assessed in 1165 pregnant women in the 1st trimester before supplementation. Using defined cutoff values, the prevalence of deficiencies of vitamins A, E, and D were 7, 25, and 14%, respectively. Nearly 33% of the women were deficient in riboflavin, and 40 and 28% had serum vitamin B-6 and B-12 deficiencies, respectively. Only 12% of the women were folate deficient, but 61% were zinc deficient. The prevalence of low serum iron concentration was 40%, and 33% were anemic (hemoglobin < 110 g/L). Multiple micronutrient deficiencies were common among pregnant women. Over 10% of the pregnant women were both anemic and deficient in B-complex vitamins, whereas 22% of women were both anemic and zinc deficient. Only 4% of women had no deficiency, whereas approximately 20% of the women had 2, 3, or 4 deficiencies. Almost 18% of women had >/=5 deficiencies. Micronutrient status varied by season; it was generally best during the winter months, except for serum vitamin D concentration, which peaked during the hot summer and monsoon months. Women in rural South Asia are likely to begin a pregnancy with multiple micronutrient deficiencies that may vary with seasonality in micronutrient-rich food availability.
发展中国家的孕妇容易出现多种微量营养素缺乏的情况。作为在尼泊尔东南部平原农村地区进行的一项基于人群的孕产妇微量营养素补充试验基线评估的一部分，我们调查了这些缺乏情况的患病率及其季节性变化。在补充前的孕早期，对1165名孕妇的11种微量营养素血清浓度进行了评估。根据确定的临界值，维生素A、E和D缺乏的患病率分别为7%、25%和14%。近33%的女性核黄素缺乏，40%和28%的女性血清维生素B-6和B-12缺乏。只有12%的女性叶酸缺乏，但61%的女性锌缺乏。血清铁浓度低的患病率为40%，33%的女性贫血（血红蛋白<110 g/L）。孕妇中多种微量营养素缺乏情况很常见。超过10%的孕妇既贫血又缺乏B族维生素，而22%的女性既贫血又锌缺乏。只有4%的女性没有缺乏情况，而约20%的女性有2种、3种或4种缺乏情况。近18%的女性有≥5种缺乏情况。微量营养素状况随季节变化；除血清维生素D浓度在炎热的夏季和季风季节达到峰值外，通常在冬季最好。南亚农村地区的女性在怀孕开始时可能就存在多种微量营养素缺乏情况，这些缺乏情况可能会随富含微量营养素食物供应的季节性而变化。
