scholarly journals Anemia and Vitamin B12 and Folate Status in Women of Reproductive Age in Southern India (P10-101-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Julia Finkelstein ◽  
Amy Fothergill ◽  
Christina Johnson ◽  
Heather Guetterman ◽  
Beena Bose ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Neural Tube ◽  
Reproductive Age ◽  
Southern India ◽  
Women Of Reproductive Age ◽  
Total Vitamin ◽  
Blood Samples ◽  
Folate Status ◽  
Defect Prevention ◽  
Study Population

Abstract Objectives To conduct a biomarker survey to examine the anemia burden and vitamin B12 and folate status in women of reproductive age as part of an ongoing periconceptional surveillance program in Southern India. Methods Participants were women of reproductive age (15–40 y) who were not pregnant or lactating and resided in households within the 50 km2 catchment area of our community-based research site in Southern India. Venous blood samples were collected at enrollment (n = 813), and whole blood samples were analyzed for hemoglobin using an automated Coulter counter. Plasma, serum, and red blood cells (RBC) were separated by centrifugation, processed, and stored <-80ºC until analysis. Total vitamin B12 was measured via chemiluminescence, and erythrocyte and serum folate concentrations were measured using the World Health Organization-recommended microbiological assay and chemiluminescence in a pilot sub-sample (n = 75) at our laboratory at St. John's Research Institute in Bangalore, India. Anemia and severe anemia were defined as hemoglobin <12.0 g/dL and <8.0 g/dL, respectively. Vitamin B12 deficiency and insufficiency were defined as total vitamin B12 < 148.0 pmol/L and <221.0 pmol/L, respectively. Folate insufficiency was defined as RBC folate <748.0 nmol/L the recommended calibrator adjusted equivalent of the optimal neural tube defect prevention threshold. Results A total of 39.1% of women in the overall study population were anemic and 2.7% had severe anemia. In the biomarker sub-sample, 18.9% of women were vitamin B12 deficient and 55.4% were vitamin B12 insufficient. Average RBC folate concentration was 486 (standard deviation: 227) nmol/L and the prevalence of RBC folate insufficiency, which is below the threshold for optimal neural tube defect prevention, was 83%. Conclusions The substantial burden of anemia, as well as vitamin B12 and folate insufficiency in this pilot study population, suggest an opportunity for prevention of neural tube defects and anemia. Findings from the biomarker survey will inform the development of a randomized efficacy trial for the prevention of anemia and birth defects in Southern India. Funding Sources Centers for Disease Control and Prevention ILSI North America Future Leader Grant AF was supported by the National Institutes of Health #5 T32 HD087137

scholarly journals Inadequate Status and Low Awareness of Folate in Switzerland—A Call to Strengthen Public Health Measures to Ensure Sufficient Intakes

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3729
Author(s):  
Isabelle Herter-Aeberli ◽  
Nina Wehrli ◽  
Kurt Bärlocher ◽  
Maria Andersson ◽  
Janice Sych
Keyword(s):  
Pregnant Women ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Online Survey ◽  
Elevated Risk ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Convenience Sample ◽  
Folate Concentration ◽  
Folate Status

Background: Folate plays an essential role in the prevention of neural tube defects, yet little is known about the folate status of women of reproductive age or to what degree the general population is aware of the importance of folate in early-life development. We aimed to determine folate status in women of reproductive age and pregnant women in Switzerland, and to assess folate awareness in the Swiss population. Methods: In a convenience sample of 171 women of reproductive age and 177 pregnant women throughout Switzerland, we measured red blood cell (RBC) folate concentration. In a second convenience sample (n = 784, men and women) we assessed folate knowledge with an online survey. Results: RBC folate concentration (median interquartile range) was 442 (366, 564) nmol/L in women of reproductive age and 873 (677, 1177) nmol/L in pregnant women. Folate deficiency (RBC folate <340 nmol/L) was found in 19.9% of women of reproductive age and 2.8% of pregnant women, while 91.8% of women of reproductive age and 52.0% of pregnant women showed folate concentrations indicating an elevated risk of neural tube defects (RBC folate <906 nmol/L). The online survey showed that a high proportion (≥88%) of participants were aware of folate’s role in neural tube defect (NTD) prevention and fetal development, yet knowledge about dietary sources and national recommendations of folate supplementation when planning pregnancy were limited. Conclusion: The high prevalence of folate inadequacy in Swiss women suggests an elevated risk of neural tube defects and calls for urgent measures to increase folate intakes.

scholarly journals Anemia and Iron Status in Women of Reproductive Age in Southern India

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 826-826
Author(s):  
Julia Finkelstein ◽  
Amy Fothergill ◽  
Heather Guetterman ◽  
Christina Johnson ◽  
Beena Bose ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Disease Control ◽  
Reproductive Age ◽  
Southern India ◽  
Deficiency Anemia ◽  
Severe Anemia ◽  
Women Of Reproductive Age ◽  
Blood Samples ◽  
Control And Prevention ◽  
Roche Diagnostics

Abstract Objectives To conduct a biomarker survey to examine the burden of anemia, iron deficiency, and inflammation in women of reproductive age in Southern India. Methods Participants were women of reproductive age (15–40 y; n = 980) who were not pregnant or lactating and resided in households within the 50 km,2 catchment area of our periconceptional surveillance program in Southern India. Venous blood samples were collected at enrollment by a trained laboratory technician at our research facility. Whole blood samples were analyzed for hemoglobin (Hb) using an automated Coulter counter. Plasma, serum, and red blood cells were separated by centrifugation, processed, and stored &lt;−80°C until analysis. Serum ferritin (SF) was measured by electrochemiluminescence (E411, Roche Diagnostics Mannheim). Soluble transferrin receptor (sTfR), C-reactive protein (CRP), and alpha-1 acid glycoprotein (AGP) were analyzed via the Roche COBAS Integra 400 plus analyzer (Roche Diagnostics). Anemia and severe anemia were defined as hemoglobin &lt;12.0 g/dL and &lt;8.0 g/dL, respectively. Serum ferritin concentrations were adjusted for inflammation using BRINDA methods. Iron deficiency was defined as SF &lt; 15.0 µg/L, and iron deficiency anemia was defined as Hb &lt; 12.0 g/dL and SF &lt; 15.0 µg/L. Inflammation was defined as elevated CRP or AGP concentrations, using established cut-offs (CRP &gt; 5.0 mg/L, AGP &gt; 1.0 g/L). Results A total of 41.1% of women were anemic and 2.9% had severe anemia. In the biomarker analyses, 53.8% of women were iron deficient (67.2% after BRINDA adjustment) and 29.1% had iron deficiency anemia (31.2% after BRINDA adjustment). A total of 14.7% of women had elevated CRP levels (&gt;5.0 mg/L) and 24.4% had elevated AGP (&gt;1.0 g/L) concentrations. Conclusions The substantial burden of anemia and iron deficiency in this study population suggest an opportunity for prevention of anemia and micronutrient deficiencies. Findings from this biomarker survey will inform the development of a randomized efficacy trial for the prevention of anemia and birth defects in Southern India. Funding Sources This study was supported by the Centers for Disease Control and Prevention (CDC), and the University of South Carolina's Disability Research and Dissemination Center through its cooperative agreement with the Centers for Disease Control and Prevention. AF was supported by the National Institutes of Health.

scholarly journals Health Education to Prevent Anemia Among Women of Reproductive Age in Southern India

2006 ◽  
Vol 27 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Pernilla Ny ◽  
Elisabeth Dejin-Karlsson ◽  
Giggi Udén ◽  
Ted Greiner
Keyword(s):  
Health Education ◽  
Reproductive Age ◽  
Southern India ◽  
Women Of Reproductive Age

scholarly journals Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study

BMJ ◽  
2018 ◽  
pp. k3609 ◽  
Author(s):  
Lisa Iversen ◽  
Shona Fielding ◽  
Øjvind Lidegaard ◽  
Lina S Mørch ◽  
Charlotte W Skovlund ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Relative Risk ◽  
Hormonal Contraception ◽  
Reproductive Age ◽  
Hormonal Contraceptives ◽  
Ovarian Cancer Risk ◽  
Women Of Reproductive Age ◽  
Ovarian Cancers ◽  
Study Population ◽  
Combined Hormonal Contraceptives

AbstractObjectivesTo investigate the association between contemporary combined hormonal contraceptives (including progestogen types in combined preparations and all progestogen-only products) and overall and specific types of ovarian cancer.DesignProspective, nationwide cohort study.SettingDenmark, 1995-2014.ParticipantsAll women aged 15-49 years during 1995-2014 were eligible. Women were excluded if they immigrated after 1995, had cancer (except non-melanoma skin cancer), had venous thrombosis, or were treated for infertility before entry (final study population included 1 879 227 women). Women were categorised as never users (no record of being dispensed hormonal contraception), current or recent users (≤1 year after stopping use), or former users (>1 year after stopping use) of different hormonal contraceptives.Main outcome measuresPoisson regression was used to calculate relative risk of ovarian cancer among users of any contemporary combined hormonal contraceptives and by progestogen type in combined preparations and all progestogen-only products, including non-oral preparations. Separate analyses examined women followed up to their first contraception type switch and those with full contraceptive histories. Duration, time since last use, and tumour histology were examined and the population prevented fraction were calculated.ResultsDuring 21.4 million person years, 1249 incident ovarian cancers occurred. Among ever users of hormonal contraception, 478 ovarian cancers were recorded over 13 344 531 person years. Never users had 771 ovarian cancers during 8 150 250 person years. Compared with never users, reduced risks of ovarian cancer occurred with current or recent use and former use of any hormonal contraception (relative risk 0.58 (95% confidence interval 0.49 to 0.68) and 0.77 (0.66 to 0.91), respectively). Relative risks among current or recent users decreased with increasing duration (from 0.82 (0.59 to 1.12) with ≤1 year use to 0.26 (0.16 to 0.43) with >10 years’ use; P<0.001 for trend). Similar results were achieved among women followed up to their first switch in contraceptive type. Little evidence of major differences in risk estimates by tumour type or progestogen content of combined oral contraceptives was seen. Use of progestogen-only products were not associated with ovarian cancer risk. Among ever users of hormonal contraception, the reduction in the age standardised absolute rate of ovarian cancer was 3.2 per 100 000 person years. Based on the relative risk for the never use versus ever use categories of hormonal contraception (0.66), the population prevented fraction was estimated to be 21%—that is, use of hormonal contraception prevented 21% of ovarian cancers in the study population.ConclusionsUse of contemporary combined hormonal contraceptives is associated with a reduction in ovarian cancer risk in women of reproductive age—an effect related to duration of use, which diminishes after stopping use. These data suggest no protective effect from progestogen-only products.

Kinetics of myo-inositol loading in women of reproductive age

2003 ◽  
Vol 40 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Pascal M.W. Groenen ◽  
Hans M.W.M. Merkus ◽  
Fred C.G.J. Sweep ◽  
Ron A. Wevers ◽  
Fokje S.M. Janssen ◽  
...  
Keyword(s):  
Neural Tube ◽  
Neural Tube Defects ◽  
Plasma Insulin ◽  
Medical Center ◽  
Serum Glucose ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Loading Test ◽  
Intracellular Signalling Pathway ◽  
Urinary Glucose

Background: Myo-inositol plays a key role in an important intracellular signalling pathway. A deranged myo-inositol metabolism has been associated with neural tube defects. A myo-inositol loading test was performed to investigate the kinetics in healthy women of reproductive age. Methods: Five healthy non-obese females {mean age (standard deviation: SD) 22·8 (2·2) years} were recruited at the University Medical Center Nijmegen. Blood samples were drawn fasting and at 20, 40, 60, 90, 180 and 270 min after ingestion of 100 mg/kg body weight of myo-inositol. Urine samples were collected before myo-inositol loading and at 180 and 270 min post-loading. Samples were analysed for serum myo-, epi- and scyllo-inositol and glucose concentrations by gas chromatography. Plasma insulin concentrations were determined by radio-immunoassay. Random intercept models were fitted to evaluate the data. Results: The estimated myo-inositol and scyllo-inositol concentrations both reached maximum values at 180 min post-loading, respectively: mean (SD) 101·5 (9·2) µmol/L and 1·09 (0·11) µmol/L. The estimated plasma insulin and serum glucose concentrations decreased slightly but significantly during the experiment: P < 0·0001 and P < 0·05, respectively. At 180 and 270 min post-loading, urinary myo-inositol concentrations were increased and urinary glucose concentrations were unchanged. Conclusions: Myo-inositol enters the bloodstream quickly after oral ingestion and a small amount of myo-inositol is converted to scyllo-inositol. The synthesis of glucose from myo-inositol could not be detected by serum measurements. These data can be used in further research into the association between myo-inositol and neural tube defects.

scholarly journals Consumption of Folic Acid–Fortified Bread Improves Folate Status in Women of Reproductive Age in Chile

2003 ◽  
Vol 133 (10) ◽  
pp. 3166-3169 ◽  
Author(s):  
Eva Hertrampf ◽  
Fanny Cortés ◽  
J. David Erickson ◽  
Marisol Cayazzo ◽  
Wilma Freire ◽  
...  
Keyword(s):  
Folic Acid ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Folate Status

scholarly journals Vitamin B12 Status and Metabolic Health in Women of Reproductive Age in Southern India

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 646-646
Author(s):  
Heather Guetterman ◽  
Krista Crider ◽  
Amy Fothergill ◽  
Beena Bose ◽  
Christina Johnson ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Metabolic Health ◽  
Reproductive Age ◽  
Whole Body ◽  
Women Of Reproductive Age ◽  
Metabolic Outcomes ◽  
B12 Deficiency ◽  
Stage 1

Abstract Objectives To examine the burden of metabolic outcomes and associations of vitamin B12 status with metabolic health in women of reproductive age (WRA), as part of a population-based biomarker survey in Chittoor, India. Methods Participants (980 WRA; 15–40y nonpregnant or lactating) were assessed for glycated hemoglobin (HbA1c; nephelometry) and serum vitamin B12 concentrations (chemiluminescence). Anthropometric measurements and systolic (SBP) and diastolic (DBP) blood pressures were collected in triplicate. Bioelectrical impedance analysis was used to evaluate whole body (WF%) and trunk (TF%) fat among women ≤ 18y. We defined elevated HbA1c as ≤ 6.5% and ≤ 5.7-&lt; 6.5%, and hypertension as stage 1 (SBP 130–139 or DBP 80–89 mmHg) and stage 2 (SBP ≤ 140 or DBP ≤ 90 mmHg). Vitamin B12 was natural logarithmically transformed prior to analyses; vitamin B12 deficiency was defined as &lt; 148 pmol/L. Linear and binomial regression models were used to examine associations of vitamin B12 status with metabolic outcomes. Results A total of 23.3% of adult WRA were overweight (body mass index (BMI): 25.0 to &lt; 30.0 kg/m2) and 9.7% had obesity (≤30.0 kg/m2). Waist circumference (WC; ≤88.9 cm) and waist-hip ratio (WHR; ≤0.85) were elevated in 13.4% and 20.1% of adult WRA. One-fourth of WRA had elevated HbA1c (≤6.5%: 5.0%; ≤5.7-&lt; 6.5%: 20.0%), and 18.6% had hypertension (stage 1: 16.4%; stage 2: 2.2%); 48.3% of WRA were vitamin B12 deficient. Higher continuous vitamin B12 concentrations were associated with lower BMI (β [standard error (SE)] -0.65 [0.28]) and WF% (-1.01 [0.50]); lower risk of elevated WC (risk ratio (RR) [95% confidence interval] 0.64 [0.49–0.85]); and higher risk of HbA1c ≤ 5.7% (1.19 [1.00–1.41]). Vitamin B12 deficiency was associated with higher BMI (β [SE] 0.98 [0.34], p = 0.004), WC (1.96 [0.76]), WF% (1.75 [0.59]), and TF% (2.03 [0.73]); and higher risk of having overweight (RR: 1.31 [1.09–1.58]), elevated WC (1.85 [1.32–2.60]), and WHR (1.38 [1.07–1.78]). Conclusions The burden of adverse metabolic outcomes was substantial in this population, and vitamin B12 deficiency was associated with central adiposity and overweight. Evaluating the role of vitamin B12 in the development of metabolic outcomes in future studies could inform screening and interventions to improve vitamin B12 status and metabolic health in WRA. Funding Sources Centers for Disease Control and Prevention.

scholarly journals Estimating the Serum Folate Concentration Associated With the Red Blood Cell Folate Threshold for Optimal Neural Tube Defects Prevention: A Population Based Biomarker Survey

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 644-644
Author(s):  
Amy Fothergill ◽  
Charles Rose ◽  
Krista Crider ◽  
Beena Bose ◽  
Heather Guetterman ◽  
...  
Keyword(s):  
Blood Cell ◽  
Vitamin B12 ◽  
Neural Tube ◽  
Red Blood Cell ◽  
Vitamin B12 Deficiency ◽  
Population Based ◽  
World Health ◽  
Serum Folate ◽  
Total Vitamin ◽  
B12 Deficiency

Abstract Objectives To estimate the serum folate insufficiency threshold (sf-IT) corresponding to the red blood cell (RBC) folate insufficiency threshold for optimal neural tube defect (NTD) prevention. Methods Participants were 977 women of reproductive age (WRA; 15–40y; not pregnant or lactating) from a population-based biomarker survey in Southern India. Venous blood samples were collected at enrollment. Plasma, serum, and red blood cells were centrifuged, processed, and stored &lt; -80°C until batch analysis. Total vitamin B12 concentrations were measured via chemiluminescence; RBC and serum folate concentrations were measured using the World Health Organization-recommended microbiological assay. Vitamin B12 deficiency was defined as total vitamin B12 &lt; 148 pmol/L. Folate insufficiency was defined as RBC folate &lt; 748 nmol/L, the recommended calibrator-adjusted equivalent of the threshold for population optimal NTD prevention. A previously developed Bayesian model and the RBC and serum folate distributions in this population were used to estimate the sf-IT corresponding to the RBC folate insufficiency threshold for optimal NTD prevention, overall and by age, body mass index (BMI) category, HbA1c, anemia, and vitamin B12 status. Results The overall estimated median sf-IT was 37.8 nmol/L (95% credible interval [33.8–43.3]). This threshold was lower in overweight WRA (BMI: ≥25.0 kg/m2: 32.0 nmol/L [27.3–40.2] vs. BMI &lt; 25.0 kg/m2: 36.2 nmol/L [32.2–43.3]), and varied by age (&lt; 25y: 61.3 nmol/L [44.3–111.8]; 25 to 35y: 35.7 nmol/L [30.8–43.5]; ≥35y: 30.8 nmol/L [26.9–37.2]). The sf-IT was lower in anemic WRA (32.9 nmol/L [28.5–40.1]) compared to non-anemic WRA (42.0 nmol/L [36.1–51.3]), and lower in WRA with elevated HbA1c (≥5.7% to &lt; 6.5: 32.4 nmol/L [27.3–41.6]; ≥6.5%: 20.9 nmol/L [17.8–25.6]) vs. WRA with HbA1c &lt; 5.7% (43.8 nmol/L, [37.5–53.7]). The median sf-IT was higher in WRA with vitamin B12 deficiency (72.1 nmol/L [52.0–126.0]), compared to women who were not vitamin B12 deficient (28.1 nmol/L [25.6–31.5]). Conclusions The estimated sf-IT is dependent on anemia, elevated HbA1c, BMI, age, and vitamin B12 status. Funding Sources Centers for Disease Control and Prevention; AF was supported by the National Institutes of Health #5 T32 HD087137.

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