Ferritin deficiency in colombian pregnant women and associated sociodemographic factors

Main Article Content

Oscar Gutierrez-Lesmes
Luz Miryam Tobón-Borrero
Javier Martínez-Torres

Abstract

Introduction: Ferritin is important in the storage of intracellular iron, in a non-toxic soluble form. Its levels during pregnancy are related to the health of the mother and her offspring. Objective: To describe the serum ferritin levels and the prevalence of ferritin deficiency, and the associated sociodemographic factors in pregnant women in Colombia. Methodology: Cross-sectional study; secondary analysis of the Nutritional Situation Survey of Colombia, 2015. The following were evaluated in 1,234 pregnant women aged between 12 and 48 years: their sociodemographic and anthropometric characteristics, the distribution of serum levels, and the prevalence of ferritin deficiency. To estimate the association between the different sociodemographic variables and serum levels, or the prevalence of ferritin deficiency, multivariate regression models were used. Results: The prevalence of ferritin deficiency was 44.5% (95% CI 40.1% to 49.0%), serum ferritin levels ranged from 4 μg/L to 295.7 μg/L, with a average of 29.3 μg/L (95% CI 26.5 μg/L - 32.2 μg/L). Pregnant women in the second (OR (OR 2.19 95% CI 1.50 to 3.19) and third trimester (OR 3.84 95% CI 2.68 to 5.50), those residing in the Atlantic region ( OR 2.18 95% CI 1.25 to 3.82) and in the Orinoquia region (OR 2.41 95% CI 1.19 to 4.88), showed an association with ferritin deficiency. Conclusion: A high prevalence of ferritin deficiency was found in Colombian pregnant women.

Keywords:
Ferritins, Pregnancy, Social Class, Food Supply, Colombia

References

Vos T, Abajobir AA, Abbafati C, Abbas KM, Abate KH, Abd-Allah F, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–59.

Kassebaum NJ, Fleming TD, Flaxman A, Phillips DE, Steiner C, Barber RM, et al. The global burden of anemia. Hematol Oncol Clin North Am. 2016;30(2):247–308.

Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum ferritin: Past, present and future. Biochim Biophys Acta. 2010;1800(8):760–9.

Knovich MA, Storey JA, Coffman LG, Torti SV, Torti FM. Ferritin for the clinician. Blood Rev. 2009;23(3):95–104.

World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in populations [Internet]. Berna-Suiza: World Health Organization; 2020. 84 p. Disponible en: https://www.who.int/publications/i/item/9789240000124

Scholl TO. Iron status during pregnancy: Setting the stage for mother and infant. Am J Clin Nutr. 2005;81(5):1218S-1222S.

Instituto Colombiano de Bienestar Familiar, Instituto Nacional de Salud. Encuesta Nacional de Salud Nutricional: Ensin 2005 [Internet]. Bogotá, Colombia; 2006. Disponible en: https://www.

icbf.gov.co/sites/default/files/libro_2005.pdf

Instituto Colombiano de Bienestar Familiar, Instituto Nacional de Salud. Encuesta Nacional de Salud Nutricional: Ensin 2010 [Internet]. Bogotá, Colombia; 2011. Disponible en: https://www.icbf.gov.co/sites/default/files/resumenfi.pdf

Instituto Colombiano de Bienestar Familiar, Instituto Nacional de Salud. Encuesta Nacional de Salud Nutricional: Ensin 2015 [Internet]. Bogotá, Colombia; 2017. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/libro-ensin-2015.pdf

Daru J, Colman K, Stanworth SJ, De La Salle B, Wood EM, Pasricha SR. Serum ferritin as an indicator of iron status: What do we need to know? Am J Clin Nutr. 2017;Suppl 6:1634S-1639S.

Quezada-Pinedo HG, Cassel F, Duijts L, Muckenthaler MU, Gassmann M, Jaddoe VWV, et al. Maternal iron status in pregnancy and child health outcomes after birth: A systematic review and meta-analysis. Nutrients. 2021;13(7):2021.

Yang J, Kang Y, Cheng Y, Zeng L, Shen Y, Shi G, et al. Iron intake and iron status during pregnancy and risk of congenital heart defects: A case-control study. Int J Cardiol. 2020;301:74–9.

Puerto A, Trojan A, Alvis-Zakzuk NR, López-Saleme R, Edna-Estrada F, Alvarez A, et al. Iron status in late pregnancy is inversely associated with birth weight in Colombia. Public Health Nutr. 2021;24(15):5090–100.

Georgieff MK. Iron deficiency in pregnancy. Am J Obstet Gynecol. 2020;223(4):516–24.

Atalah E, Castillo L C, Castro R, Aldea PA. Propuesta de un nuevo estándar de evaluación nutricional en embarazadas. Rev Med Chile. 1997;1429–36.

Organización de las Naciones Unidas para la Alimentación y la Agricultura. Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA): Manual de uso y aplicación. [Internet]. 2012. Disponible en: http://www.fao.org/3/i3065s/i3065s.pdf

Filmer D, Pritchett LH. Estimating wealth effects without expenditure data -Or tears: An application to educational enrollments in states of India. Demography. 2001;38(1):115–32.

Departamento Administrativo Nacional de Estadística. Ficha Metodológica Déficit de Vivienda

[Internet]. 2008. Disponible en: https://www.dane.gov.co/files/investigaciones/boletines/censo/FM_deficitvivienda.pdf

Copeland KR, Ganesh N. Sample Weighting for Health Surveys. En: Timothy P J, editor. Handbook of Health Survey Methods. John Wiley & Sons, Inc.; 2015. p. 669–94.

Martínez-Torres J, Gutiérrez-Lesmes OA. Componentes éticos mínimos que debe tener la investigación clínica. Rev Criterios. 2017;24(1):15–7.

Rincón-Pabón D, Urazán-Hernández Y, Gonzalez-Santamaria J. Prevalencia y factores sociodemográficos asociados a anemia ferropénica en mujeres gestantes de Colombia (análisis secundario de la ENSIN 2010). Nutr Hosp. 2018;36(1):87–95.

da Costa AG, Vargas S, Clode N, Graça LM. Prevalence and risk factors for iron deficiency anemia and iron depletion during pregnancy: A prospective study. Acta Med Port. 2016;29(9):514–8.

Ramirez-Velez R, Gonzalez-Ruiz K, Correa-Bautista J, Martinez-Torres J, Meneses-Echavez JF, Rincon-Pabon D. Ferritin levels in pregnant Colombian women. Nutr Hosp. 2015;31(2):793–7.

Zhang N, Mei L, Li M, Zhang Y, Xu J, Li M, et al. Prevalence and associated factors for iron deficiency anemia among pregnant women in Fuyang, China. Women Heal. 2021;61(10):997–1006.

Tan J, He G, Qi Y, Yang H, Xiong Y, Liu C, et al. Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey. BMC Pregnancy Childbirth. 2020;20:670.

Eltayeb R, Rayis DA, Sharif ME, Ahmed ABA, Elhardello O, Adam I. The prevalence of serum magnesium and iron deficiency anaemia among Sudanese women in early pregnancy: A crosssectional study. Trans R Soc Trop Med Hyg. 2019;113(1):31–5.

Arija V, Ribot B, Aranda N. Prevalence of iron deficiency states and risk of haemoconcentration during pregnancy according to initial iron stores and iron supplementation. Public Health Nutr. 2013;16(8):1371–8.

Pobee RA, Setorglo J, Klevor M, Murray-Kolb LE. The prevalence of anemia and iron deficiency among pregnant Ghanaian women, a longitudinal study. Plos One. 2021;16(3):e0248754.

Ajepe AA, Okunade KS, Sekumade AI, Daramola ES, Beke MO, Ijasan O, et al. Prevalence and foetomaternal effects of iron deficiency anaemia among pregnant women in Lagos, Nigeria. Plos One. 2020;15(1):e0227965.

Martínez-Torres J, Gutierrez-Lesmes OA, Rangel H, Córdoba-Castro J, Anaya-Baldovino JI, Celis- Parra DM. Niveles de inseguridad alimentaria y características asociadas en mujeres gestantes de Colombia en el 2015. Med Fam Semer. 2022;48(6):369–76.

Park CY, Eicher-Miller HA. Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey. J Acad Nutr Diet. 2014;114(12):1967–73.