Abstract
OBJECTIVES: To examine the burden of anemia and deficiencies of iron, vitamin B(12), 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 7658 women of reproductive age (12–49 y; n = 7383 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 B(12), 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 B(12) 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 B(12) deficiency, 23.9% had vitamin B(12) 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 B(12) deficient, and 55.4% were vitamin B(12) insufficient. In non-pregnant WRA, higher SF (P < 0.0001), vitamin B(12) (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 B(12) insufficiency is high among women of reproductive age in Ecuador. FUNDING SOURCES: Not applicable.