The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Iron status and risk factors of iron deficiency among pregnant women in Singapore: A cross-sectional study

Iron status and risk factors of iron deficiency among pregnant women in Singapore: A cross-sectional study
Iron status and risk factors of iron deficiency among pregnant women in Singapore: A cross-sectional study
Background Iron deficiency is the most prevalent nutrient deficiency and the most common cause of anaemia worldwide. Because of the increased iron requirements during pregnancy, iron deficiency can lead to maternal anaemia and reduced newborn iron stores. We examined the proportion and risk factors of iron deficiency among pregnant women in a developed Asian country. Methods Within a prospective cohort in Singapore, 985 Asian women were assessed for iron status at 26–28 weeks’ gestation, with plasma ferritin and soluble transferrin receptor (sTfR) measurements. Iron status was determined according to plasma ferritin concentrations at ≥30 μg/L (iron sufficiency), 15 to < 30 μg/L (modest iron depletion) and < 15 μg/L (severe iron depletion). Multivariable ordinal logistic regression was used to analyze risk factors for modest and severe iron depletion. Results The median (25-75th percentile) plasma ferritin concentration was 24.2 (19.9–30.6) μg/L. Overall, 660 (67.0%) and 67 (6.8%) women had modest and severe iron depletion, respectively. Higher plasma sTfR was observed in women with severe iron depletion than among those with iron sufficiency (median 17.6 versus 15.5 nmol/L; p < 0.001). Age < 25 years (odds ratio 2.36; 95% confidence interval 1.15–4.84), Malay (2.05; 1.30–3.24) and Indian (1.98; 1.14–3.44) ethnicities (versus Chinese), university qualification (1.64; 1.13–2.38), multiparity (1.73; 1.23–2.44) and lack of iron-containing supplementation (3.37; 1.25–8.53) were associated with increased odds of modest and severe iron depletion. Conclusions Nearly three-quarters of Singaporean women were iron deficient in the early third trimester of pregnancy. These results suggest universal screening and supplementation of at-risk pregnancies may be evaluated as a preventive strategy.
1471-2458
Loy, See Ling
6fd10b64-1de2-419e-a5f4-b505be233e6e
Lim, Li Min
cf98f0a0-8604-4e78-a486-61d0485cc3e0
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Tan, Pei Ting
2c508cdb-d1b3-4856-9633-21f89b080863
Chee, Yen Lin
fa50f9f4-4686-4daf-9ef3-5fb979c35117
Quah, Phaik Ling
e0f2f623-bf5c-4ab8-8a57-b64be57e3ede
Chan, Jerry Kok Yen
42e59d61-c3d1-486b-b33a-22c4645acf12
Tan, Kok Hian
672ae6c4-d4c8-4b1b-8512-efec36431503
Yap, Fabian
22f6b954-31fc-4696-a52b-e985a424b95b
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Shek, Lynette Pei-Chi
ff5b44bf-5ab5-4249-8cf1-21751a4f6ae8
Chong, Mary Foong-Fong
1e188259-b1ab-4448-9e65-5b6a0fd99502
Kramer, Michael S.
8af13d8f-cdb6-4bfb-a37a-aac9bee0d0c3
Chong, Yap-Seng
7043124b-e892-4d4b-8bb7-6d35ed94e136
Chi, Claudia
5d30e55d-884d-42f9-8f18-814db5563fb1
Loy, See Ling
6fd10b64-1de2-419e-a5f4-b505be233e6e
Lim, Li Min
cf98f0a0-8604-4e78-a486-61d0485cc3e0
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Tan, Pei Ting
2c508cdb-d1b3-4856-9633-21f89b080863
Chee, Yen Lin
fa50f9f4-4686-4daf-9ef3-5fb979c35117
Quah, Phaik Ling
e0f2f623-bf5c-4ab8-8a57-b64be57e3ede
Chan, Jerry Kok Yen
42e59d61-c3d1-486b-b33a-22c4645acf12
Tan, Kok Hian
672ae6c4-d4c8-4b1b-8512-efec36431503
Yap, Fabian
22f6b954-31fc-4696-a52b-e985a424b95b
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Shek, Lynette Pei-Chi
ff5b44bf-5ab5-4249-8cf1-21751a4f6ae8
Chong, Mary Foong-Fong
1e188259-b1ab-4448-9e65-5b6a0fd99502
Kramer, Michael S.
8af13d8f-cdb6-4bfb-a37a-aac9bee0d0c3
Chong, Yap-Seng
7043124b-e892-4d4b-8bb7-6d35ed94e136
Chi, Claudia
5d30e55d-884d-42f9-8f18-814db5563fb1

Loy, See Ling, Lim, Li Min, Chan, Shiao-Yng, Tan, Pei Ting, Chee, Yen Lin, Quah, Phaik Ling, Chan, Jerry Kok Yen, Tan, Kok Hian, Yap, Fabian, Godfrey, Keith, Shek, Lynette Pei-Chi, Chong, Mary Foong-Fong, Kramer, Michael S., Chong, Yap-Seng and Chi, Claudia (2019) Iron status and risk factors of iron deficiency among pregnant women in Singapore: A cross-sectional study. BMC Public Health, 19 (397). (doi:10.1186/s12889-019-6736-y).

Record type: Article

Abstract

Background Iron deficiency is the most prevalent nutrient deficiency and the most common cause of anaemia worldwide. Because of the increased iron requirements during pregnancy, iron deficiency can lead to maternal anaemia and reduced newborn iron stores. We examined the proportion and risk factors of iron deficiency among pregnant women in a developed Asian country. Methods Within a prospective cohort in Singapore, 985 Asian women were assessed for iron status at 26–28 weeks’ gestation, with plasma ferritin and soluble transferrin receptor (sTfR) measurements. Iron status was determined according to plasma ferritin concentrations at ≥30 μg/L (iron sufficiency), 15 to < 30 μg/L (modest iron depletion) and < 15 μg/L (severe iron depletion). Multivariable ordinal logistic regression was used to analyze risk factors for modest and severe iron depletion. Results The median (25-75th percentile) plasma ferritin concentration was 24.2 (19.9–30.6) μg/L. Overall, 660 (67.0%) and 67 (6.8%) women had modest and severe iron depletion, respectively. Higher plasma sTfR was observed in women with severe iron depletion than among those with iron sufficiency (median 17.6 versus 15.5 nmol/L; p < 0.001). Age < 25 years (odds ratio 2.36; 95% confidence interval 1.15–4.84), Malay (2.05; 1.30–3.24) and Indian (1.98; 1.14–3.44) ethnicities (versus Chinese), university qualification (1.64; 1.13–2.38), multiparity (1.73; 1.23–2.44) and lack of iron-containing supplementation (3.37; 1.25–8.53) were associated with increased odds of modest and severe iron depletion. Conclusions Nearly three-quarters of Singaporean women were iron deficient in the early third trimester of pregnancy. These results suggest universal screening and supplementation of at-risk pregnancies may be evaluated as a preventive strategy.

Text
manuscript_BMC Public Health_revised 27Feb2019_clean - Accepted Manuscript
Restricted to Registered users only
Download (209kB)
Request a copy
Text
s12889-019-6736-y - Version of Record
Available under License Creative Commons Attribution.
Download (767kB)
Text
Figure 1
Restricted to Registered users only
Download (60kB)
Request a copy
Text
additional file 1
Restricted to Registered users only
Download (65kB)
Request a copy
Text
additional file 2
Restricted to Registered users only
Download (65kB)
Request a copy

Show all 5 downloads.

More information

Accepted/In Press date: 2 April 2019
e-pub ahead of print date: 11 April 2019

Identifiers

Local EPrints ID: 430255
URI: http://eprints.soton.ac.uk/id/eprint/430255
ISSN: 1471-2458
PURE UUID: 0f5d3319-b8fe-4299-a5b7-e6c5a62ecd5d
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 23 Apr 2019 16:30
Last modified: 22 Nov 2021 02:36

Export record

Altmetrics

Contributors

Author: See Ling Loy
Author: Li Min Lim
Author: Shiao-Yng Chan
Author: Pei Ting Tan
Author: Yen Lin Chee
Author: Phaik Ling Quah
Author: Jerry Kok Yen Chan
Author: Kok Hian Tan
Author: Fabian Yap
Author: Keith Godfrey ORCID iD
Author: Lynette Pei-Chi Shek
Author: Mary Foong-Fong Chong
Author: Michael S. Kramer
Author: Yap-Seng Chong
Author: Claudia Chi

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×