Abstract

Background: Although the effect of micronutrient deficiency during pregnancy is well established, burden of co-occurrence of iron, folate, and vitamin A deficiency and factors associated with this are less explored in countries like Ethiopia. In this study, we assessed the burden of co-occurrence of iron, folate, and vitamin A deficiency among pregnant women residing in eastern Ethiopia. In addition, we identified factors associated with deficiency of these micronutrients.

Methods: A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. In this study, 397 women who had all micronutrient test results were included in the analysis. The blood serum collected using standard techniques from pregnant women to assess ferritin (SF), serum folate and retinol concentrations were shipped to Ethiopian public health institution for micronutrient analysis. Factors associated with co-occurrence of iron, folate, and vitamin A deficiency were identified using binary and multiple logistic regressions. Association was described using adjusted odd ratio (AOR) along with 95% confidence interval (CI). Finally, p-value <0.05 was considered as the cut-off point for declaring significant association.

Results:

Overall, half of the study participants had ≥2 micronutrient deficiencies during the study period. The risk of co-occurrence of iron, folate, and vitamin A deficiency was 2.44 times more likely among women who didn’t receive Iron–folic acid (IFA) supplementation (AOR=2.44; 95% CI=1.52-3.92), 2.88 times more likely among who didn’t attend Antenatal care (ANC) follow up (AOR=2.88; 95% CI=1.81-4.61,) and 2.18 time more likely among those who reported low consumption of diversified diet (AOR=2.18 (95% CI=1.35-3.51) compared to their counterparts, respectively.

Conclusion: We found that more than a half of pregnant women had co-occurrence of iron, folate, and vitamin A deficiency, indicating a major public health problem. Ensuring women get quality ANC services and access to nutrition information is important to optimize food and nutrient intakes during pregnancy. There is a need towards multiple micronutrients supplementation in addition to IFA supplementation programs, which are already in place.

Keywords: Co-occurrence, micronutrient deficiency, pregnant women, ferritin, retinol, vitamin A, Ethiopia.