Association of Colecalciferol, Ferritin, and Anemia among Pregnant Women: Result from Cohort Study on Vitamin D Status and Its Impact during Pregnancy and Childhood in Indonesia

Abstract

Studies had shown that iron-cycling was disturbed by inflammatory process through the role of hepcidin. Pregnancy is characterized by shifts of interleukin. Our objective was to determine if 25(OH) vitamin D (colecalciferol) status was associated with ferritin, anemia, and its changes during pregnancy. Method. A cohort study was done in 4 cities in West Java, Indonesia, beginning in July 2016. Subjects were followed up until third trimester. Examinations included were maternal ferritin, colecalciferol, and haemoglobin level. Result. 191 (95.5%) subjects had low colecalciferol, and 151 (75.5%) among them were at deficient state. Anemia is found in 15 (7.5%) subjects, much lower than previous report. Proportion of anemia increased by trimester among women with colecalciferol deficiency. Ferritin status and prepregnancy body mass index in the first trimester were correlated with anemia (r = 0.147, p = 0.038 and r = −0.56, p = 0.03). Anemia in the second trimester was strongly correlated with anemia in the third trimester (r = 0.676, p < 0.01). Conclusion. Our study showed that the state of colecalciferol was not associated with either ferritin state or anemia, but proportion of anemia tends to increase by trimester in the colecalciferol deficient subjects.

Association of maternal vitamin D deficiency and infants' neurodevelopmental status: A cohort study on vitamin D and its impact during pregnancy and childhood in Indonesia

“…The prevalence of vitamin D deficiency among pregnant women ranges from 20 to over 90% . Previous research conducted in Bandung, Cimahi, Sukabumi and Waled stated that 75.6% of pregnant women experience vitamin D deficiency (<20 ng/mL) in the first trimester . Women are at increased risk of experiencing these conditions because of poor dietary intake, prolonged indoor stay and reduced ultraviolet exposure due to cultural clothing practices.…”

First Trimester Ferritin Is Superior over Soluble Transferrin Receptor and Hepcidin in Predicting Anemia in the Third Trimester: Result from a Cohort Study in Indonesia

“…Another report concluded that maternal anemia increased the risk for small for gestational babies [ 4 ]. The cohort study in which this study was nested also reported high prevalence of anemia and hypovitaminosis D and intrauterine growth restriction (10%) [ 5 – 7 ]. Reports stated that the prevalence of anemia increased by gestational age [ 5 , 8 ].…”

“…Reports stated that the prevalence of anemia increased by gestational age [ 5 , 8 ]. In the pregnancy cohort of this study, anemia had 4-fold increase of prevalence in the third trimester, and relative risk (95% CI) for anemia in the third trimester among subjects with vitamin D deficiency and insufficiency in the first trimester (combined) was 2.96 (0.36–24.63) [ 5 ].…”

“…From the cohort of this study, it was reported that the correlation of ferritin level and anemia in the first trimester was weak ( r = 0.147, p =0.038), but no correlation was found between first trimester ferritin level and second or third trimester anemia [ 5 ]. For public health and clinical purposes, we need to use the best available evidence.…”

“…This diagnostic study aimed at finding the best marker in the first trimester to predict anemia in the third trimester. Our previous report showed that the proportion of anemia in the third trimester increased among pregnant women with cholecalciferol deficiency in the first trimester, but it did not show correlation with the ferritin level [ 5 ]. Three markers were picked: hepcidin, ferritin, and soluble transferrin receptor.…”