Assessment of Folic Acid Supplementation in Pregnant Women by Estimation of Serum Levels of Tetrahydrofolic Acid, Dihydrofolate Reductase, and Homocysteine

Naithani, Manisha; Saxena, Vartika; Mirza, Anissa Atif; Kumari, Ranjeeta; Sharma, Kapil; Bharadwaj, Jyoti

doi:10.1155/2016/1520685

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…Nearly 50% of all anaemia can be attributed to iron deficiency [1,2]. Folic acid is also a vital micronutrient required for the metabolism, foetal growth, and the development of the neural tube [3]. Globally, the estimated prevalence of anaemia among nonpregnant and pregnant women was 29% and 38%, respectively, whereas, in Africa, the estimated proportions were 37.8% and 46.3%, respectively [2].…”

Section: Introductionmentioning

confidence: 99%

“…These include biological changes (menstrual period), undernutrition attributed to poverty, food insecurity, gender inequalities, inadequate knowledge of proper dietary practices, and increased iron and folic acid deficiency [5]. Furthermore, pregnant women experience increased micronutrient demand especially iron for the growth of foetus and metabolism which cannot be easily met by diet alone because of the poor intake and low absorption of iron [3].…”

Section: Introductionmentioning

confidence: 99%

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Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania

Lyoba

Mwakatoga

Festo

et al. 2020

International Journal of Reproductive Medicine

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Introduction. Pregnant women are at a high risk of anaemia, with iron-folate deficiency being the most common cause of anaemia among pregnant women. Despite the well-known importance of iron and folic acid supplementation (IFAS) during pregnancy, adherence to these supplements is relatively low and associated factors were not well identified in the study area. This study is aimed at investigating adherence to IFAS and associated factors among pregnant women in Kasulu district, north-western Tanzania. Methods. A health facility cross-sectional survey with a mixed-method approach was conducted in Kasulu district from March to April 2019. A structured questionnaire was given to 320 women with children aged 0-6 months to assess factors associated with adherence to IFAS among pregnant women. Data were entered into SPSS version 22.0 for analysis. Binary logistic regression was further employed to determine the factors associated with adherence to IFAS. Focus group discussions were done with 19 pregnant women and 15 mothers of children aged 0-6 months to obtain more clarifications on the factors associated with adherence to IFAS. Furthermore, in-depth interviews were done with six health care providers to explore their perceptions of IFAS. Results. Out of the 320 respondents of the survey, 20.3% (n=65) adhered to IFAS. Factors associated with adherence to IFAS among pregnant women included time to start ANC (AOR=3.72, 95% CI: 1.42, 9.79), knowledge of anaemia (AOR=3.84, 95% CI: 1.335, 10.66), counseling on the importance of the iron-folic acid (AOR=3.86, 95% CI: 1.42, 10.50), IFAS given during clinical visit (AOR=15.72, 95% CI: 5.34, 46.31), number of meals consumed (AOR=3.44, 95% CI: 1.28, 9.21), number of children (AOR=3.462, 95% CI: 1.035, 11.58), and distance to health facility (AOR=0.34, 95% CI: 0.131, 0.886). Qualitative findings revealed that delayed first ANC visit, lack of remainder for pregnant women to take IFAS, low awareness about the negative effects of anaemia, low of knowledge of IFAS and management of side effects, negative beliefs about the use of IFAS, and follow-up mechanism were major reasons for poor adherence. Conclusion. Adherence to iron-folic acid supplementation during pregnancy was low. Strengthening systems for creating reminding mechanism, raising community awareness through educational programs to pregnant women and health providers could improve adherence to IFAS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania

Lyoba

Mwakatoga

Festo

et al. 2020

International Journal of Reproductive Medicine

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“…Although DHFR enzyme levels have been analyzed in cancer cell cultures (Mishra et al , 2007), to our knowledge our study is the first to analyze the association of DHFR enzyme concentrations in RA patients with DHFR −829C-T genotypes. All of our patients had levels more than 6.1 ± 3.1 ng/mL, which suggests that patients with RA have DHFR enzyme overexpression relative to that seen in healthy populations (Naithani et al , 2016). Galbiatti et al (2013) found that DHFR gene expression levels in cancer cells dose-dependently increased with MTX treatment.…”

Section: Discussionmentioning

confidence: 59%

miRNA-24 Gene Sequence, DHFR −829C-T Genotypes, and Methotrexate Response in Mexican Patients with Rheumatoid Arthritis

Hernández-Preciado

Morán-Moguel

Dávalos-Rodríguez

et al. 2019

Genetic Testing and Molecular Biomarkers

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Aim: The present study looked for variation in the miRNA-24 sequence, and evaluated the associations between the dihydrofolate reductase ( DHFR ) gene-829 C-T polymorphism and plasma DHFR concentrations with response to methotrexate (MTX) treatment in Mexican patients with rheumatoid arthritis (RA). Methods: A total of 135 women with RA were classified as responders (disease activity score [DAS28] <3.2) or nonresponders to MTX (DAS28 > 3.2). We determined the genotype of the patients using the polymerase chain reaction-restriction fragment length polymorphism method. Plasma DHFR enzyme levels and mi-RNA24 sequences were assessed by enzyme-linked immunosorbent assay (ELISA) and Sanger sequencing, respectively. Allelic frequencies and the genotypic distribution of the polymorphism were analyzed by the chi-square test. Results: The genotype frequencies of the DHFR −829C-T polymorphism among responders were 37.0% CC, 52.1% CT, and 10.9% TT and for nonresponders were 33.9% CC, 56.4% CT, and 9.7% TT. No significant differences in genotype frequencies were found between the groups ( p = 0.88). The DHFR levels relative to genotype for responders were 6.8 ± 2.7, 6.1 ± 2.7, and 6.5 ± 1.5 ng/mL for CC, CT, and TT, respectively, and for nonresponders were 6.5 ± 2.0, 6.1 ± 3.1, and 7.4 ± 1.8 ng/mL for CC, CT, and TT, respectively. No significant differences were found between the two groups. Similarly, both groups showed no sequence variations in miRNA-24 gene. Conclusion: The −829C-T polymorphism of DHFR gene was not associated with response to MTX by RA patients, and no variations were found in the miRNA-24 sequence that might modify the response to treatment or DHFR enzyme levels in a Mexican population with RA.

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“…The majority of pregnant females and healthcare providers tend to ignore folic acid (FA) supplementation in the first trimester [ 2 ]. Very few studies have been conducted in India on the awareness of pregnant women regarding FA supplementation, providing comprehensive information about their current knowledge and its determinants [ 3 , 4 ]. Globally, the prevalence of NTDs among newborns is approximately 1-5/1000 live births with a 2%-3% risk of recurrence [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…There has been no such study in Chhattisgarh and eastern India, which assessed the awareness regarding FA supplementation among pregnant women. Furthermore, very few studies have estimated serum FA and vitamin B12 levels among pregnant women and assessed the correlation between them [ 4 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Awareness About Folic Acid Supplementation in First-Trimester Pregnant Women of Rural Raipur District, Chhattisgarh, and Its Determinants: A Cross-Sectional Study

Pal¹,

Shukla²,

Santra³

et al. 2023

Cureus

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Background: Women are supplemented with folic acid (FA) during pregnancy as well as preconceptionally to prevent neural tube defects (NTDs) in newborns. To understand the importance of FA supplementation, women need to have awareness about the same, which in turn may be influenced by different factors. It is also known that both FA and vitamin B12 deficiency tend to cause NTDs in newborns and anemia. Very few studies have studied the relationship between hemoglobin, FA, and vitamin B12 levels. In this study, we aim to estimate the level of awareness of FA supplementation among pregnant women in the first trimester of pregnancy and the factors determining the presence of awareness regarding the same. Also, we aim to estimate any correlation between hemoglobin, FA, and vitamin B12 levels among a subset of pregnant women. Methods: A cross-sectional study was conducted in the Abhanpur Block of Raipur district in Chhattisgarh among 399 pregnant women in their first trimester of pregnancy, in which their knowledge was assessed using a pretested semistructured questionnaire. Each participant's knowledge score regarding FA supplementation was calculated and scored based on six indicators and classified as low, intermediate, and high scores. Logistic regression was applied to find out any significant association between knowledge about FA supplementation with any other sociodemographic variables. Scatter plots were used to assess the correlation of FA with hemoglobin, vitamin B12, and knowledge scores among 104 participants. Results: The majority (77.9%) of women had low knowledge scores with a mean score of 1.4 (0.15). It was found that only 45.6% of the participants knew the importance of FA supplementation, and the majority (23.1%) were informed by auxiliary nurse midwives (ANMs) followed by doctors. The majority (41.6%) of the study participants also did not know when to start FA, and only 1.3% knew that FA should be taken preconceptionally. On multivariable logistic regression, women who lived in joint families had significantly higher odds of having intermediate knowledge compared to those who lived in nuclear families. Although not statistically significant, there was a positive correlation between serum vitamin B12 and FA levels and also between hemoglobin and serum FA levels. However, a significant positive correlation was found between serum FA levels and the knowledge scores of the study participants. Conclusion: The majority of study participants had poor knowledge and awareness regarding FA supplementation. So, health education, as well as information, education, and communication (IEC) activities, is required to improve the knowledge about FA supplementation among women of reproductive age in the community. A better understanding of FA supplementation can lead to adherence to FA consumption and prevent NTDs among newborns.

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Assessment of Folic Acid Supplementation in Pregnant Women by Estimation of Serum Levels of Tetrahydrofolic Acid, Dihydrofolate Reductase, and Homocysteine

Cited by 3 publications

References 16 publications

Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania

Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania

miRNA-24 Gene Sequence, DHFR −829C-T Genotypes, and Methotrexate Response in Mexican Patients with Rheumatoid Arthritis

Awareness About Folic Acid Supplementation in First-Trimester Pregnant Women of Rural Raipur District, Chhattisgarh, and Its Determinants: A Cross-Sectional Study

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