Topical Area: Global Nutrition

Objectives : To examine the burden of anemia and deficiencies of iron, vitamin B₁₂, and folate in women of reproductive age (WRA) in Ecuador.  

Methods : Data from the 2012 Ecuadorian National Health and Nutrition Survey (ENSANUT-ECU) were analyzed to examine the burden of anemia and micronutrient deficiencies among 7,658 women of reproductive age (12-49 y; n=7,383 non-pregnant, n=275 pregnant). Venous blood samples were collected, and hemoglobin (Hb) was assessed viathe sodium lauryl sulfate method. Samples were centrifuged, processed, and stored < -50ºC until analysis. Serum ferritin (SF), vitamin B₁₂, serum folate, and red blood cell (RBC) folate were measured viachemiluminescence. Hemoglobin was adjusted for altitude; and anemia was defined as Hb< 11.0 g/dL in pregnant women and < 12.0 g/dL in non-pregnant women. Iron deficiency and insufficiency were defined as SF< 15.0 µg/L and < 20.0 µg/L, respectively. Vitamin B₁₂ deficiency and insufficiency were defined as < 148.0 pmol/L and < 221.0 pmol/L; and folate deficiency was defined as serum folate< 7.0 nmol/L and RBC folate< 342.0 nmol/L. Survey logistic and linear regression were used to examine associations of micronutrients with hemoglobin concentrations and anemia.

Results : In analyses among non-pregnant women, 11.3% were anemic, 14.4% were iron deficient, and 21.1% had iron insufficiency. A total of 4.3% of women had vitamin B₁₂ deficiency, 23.9% had vitamin B₁₂ insufficiency; and < 1% of women were folate deficient. The prevalence of micronutrient deficiencies was higher in pregnant women, compared to non-pregnant women: 31.1% of pregnant women were iron deficient, 43.0% were iron insufficient, 21.3% were vitamin B₁₂ deficient, and 55.4% were vitamin B₁₂ insufficient. In non-pregnant WRA, higher SF (p< 0.0001), vitamin B₁₂ (p< 0.01), and serum folate (p< 0.0001) concentrations were associated with higher Hb concentrations; and higher SF (OR: 0.96, 95% CI: 0.95, 0.97; p< 0.0001) and serum folate (OR: 0.98, 95% CI: 0.97, 0.98; p< 0.0001) concentrations were associated with lower odds of anemia. In pregnant women, SF (p< 0.01) and serum folate (p=0.002) concentrations were associated with higher hemoglobin concentrations.

Conclusions :

Findings suggest that the burden of anemia, iron deficiency, and vitamin B₁₂ insufficiency is high among women of reproductive age in Ecuador. 

Funding Sources : Not applicable

Presenting Author(s)

• CG

  Cristina Guitron Leal

  Graduate Student
  Division of Nutritional Sciences, Cornell University

Co-Author(s)

• JF

  Julia Finkelstein

  Division of Nutritional Sciences, Cornell University

• WC

  Winnie Chu

  Medical Student
  Cornelll University

• JK

  Jesse Krisher

  Statistical Analyst
  Division of Nutritional Sciences, Cornell University

• JH

  Jere Haas

  DIvision of Nutritional Sciences, Cornell University

• SM

  Saurabh Mehta

  Division of Nutritional Sciences, Cornell University

• WF

  Wilma Freire

  Professor
  Universidad San Francisco de Quito, Ecuador