Epidemiological determinants of Folate deficiency among pregnant women of district Dehradun

BackgroundFolate deficiency has been found to be associated with congenital birth defects like spina bifida, anencephaly, etc. Pregnant women have an increased need for folic acid (600 μg/day) to support the growth of the placenta and foetus and prevent birth defects.ObjectivesThe present study was conducted to assess deficiency of serum folate among pregnant women and its epidemiological determinants.MethodsA cross-sectional study was conducted in the Doiwala block of Uttarakhand state, a hilly state of the country, and a total of 95 pregnant women participated. Pregnant women were randomly selected from antenatal clinics organized at sub-centres and primary health centres. Blood samples were analyzed for serum folate by competitive immunoassay using direct chemiluminescent technology. Fully automated ADVIA Centaur XP Immunoassay system was used for analysis.ResultsAnalysis of data showed that mean serum folate level among pregnant women was 10.1 ± 5.9 ng/ml (95% confidence interval 8.9-11.2). As per World Health Organization cut-off levels, a total of 28 (29.4%), 95% CI (20.2-38.5), women were having folate deficiency (≤5.9 ng/ml), and out of them 3 were having folate levels below 3 ng/ml (severe folate deficiency). 9 (9.4%) women had elevated levels (>20 ng/ml). 57 (60%) women were in the normal range (6-20 ng/ml).Out of various biosocial determinants considered, education and economic status have shown significant association with folate deficiency. A significant difference was observed in the mean serum folate level among pregnant women living in joint and nuclear type of family. Mean serum folate levels showed a slight negative correlation with body mass index (Spearman's rho = −0.22, p = 0.03900) and gestational age (correlation coefficient: r = −0.26, p = 0.009).ConclusionIt is concluded that higher level of education, living in joint family during pregnancy and availability of designated APL (Above Poverty Line) or BPL (Below Poverty Line) card are important determinants for better serum folate level and lower chances of folate deficiency.