Folate and Vitamin B12 Status among Non-Pregnant, Non-Lactating Women of Reproductive Age and Predicted Risk for Neural Tube Defects, Morogoro Region, Tanzania.

IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Cara T Mai, Kaitlyn Long, Tedson Lukindo, Shameem Jabbar, John Gwakisa, Jorge Rosenthal, Mindy Zhang, Lorraine F Yeung, Amy Fothergill, Arick Wang, Kaunara Azizi, Dorah Chilumba, Jennifer L Williams, Christine M Pfeiffer, Elise Caruso, Germana H Leyna, Rogath Kishimba
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引用次数: 0

Abstract

Introduction: Population risk for neural tube defects (NTDs) can be determined using red blood cell (RBC) folate. However, a paucity of biomarker and surveillance data among non-lactating, non-pregnant women of reproductive age (NPWRA) from Africa limits accurate assessment. Our study assessed folate and vitamin B12 status among non-lactating NPWRA and predicted population risk of NTDs in Tanzania.

Methods: A cross-sectional biomarker survey of non-lactating NPWRA (15-49 years) in the Morogoro region, Tanzania was conducted during June-October 2019. Questionnaire interview responses and non-fasting blood samples were collected. Folate was assessed using the CDC microbiologic assay kit and vitamin B12 was measured using an electrochemiluminescence immunoassay. Complex survey design analyses were conducted using SAS-callable SUDAAN (v11.0.1).

Results: Of the 761 participating non-lactating NPWRA, 294 (39.8%) had RBC folate insufficiency (<748 mol/L). The prevalence of RBC folate insufficiency was lower among non-lactating NPWRA living in urban than rural areas (PR: 0.72, 95% CI: 0.52-0.99) but did not differ by age or household wealth index. Vitamin B12 insufficiency was uncommon (< 221 pmol/L, 2.7%). The estimated NTD risk was 10.5 (95% uncertainty interval: 8.1-13.3) per 10,000 births.

Discussion: Elevated NTD risk was predicted in the Morogoro region of Tanzania, where ∼ 40% of non-lactating NPWRA had RBC folate insufficiency and < 3% had vitamin B12 insufficiency. The NTD risk is consistent with surveillance data for the area, limited folic acid fortification of staple foods, and low vitamin B12 insufficiency. Further studies are needed to better understand the context of these findings, especially the impact of micronutrient fortification in Tanzania.

坦桑尼亚莫罗戈罗地区非怀孕、非哺乳期育龄妇女叶酸和维生素B12状况与神经管缺陷的预测风险
导论:神经管缺陷(NTDs)的人群风险可以用红细胞(RBC)叶酸测定。然而,非洲非哺乳期、非妊娠育龄妇女(NPWRA)的生物标志物和监测数据的缺乏限制了准确的评估。我们的研究评估了坦桑尼亚非哺乳期NPWRA的叶酸和维生素B12状况,并预测了NTDs的人群风险。方法:2019年6月至10月,对坦桑尼亚莫罗戈罗地区非哺乳期NPWRA(15-49岁)进行了横断面生物标志物调查。收集问卷访谈回答和非空腹血液样本。使用CDC微生物测定试剂盒评估叶酸,使用电化学发光免疫测定法测量维生素B12。使用sas可调用的SUDAAN (v11.0.1)进行复杂的调查设计分析。结果:在761名参与非哺乳期NPWRA的患者中,294名(39.8%)存在红细胞叶酸不足(讨论:在坦桑尼亚的Morogoro地区,预测NTD风险升高,其中约40%的非哺乳期NPWRA存在红细胞叶酸不足
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来源期刊
Maternal and Child Health Journal
Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.20
自引率
4.30%
发文量
271
期刊介绍: Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.
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