Micronutrient Deficiencies in Ghanaian Women before Pregnancy

Micronutrient deficiencies have received little attention compared to other global health issues, in spite of their extreme importance for reproductive outcomes. Pregnancy increases nutritional demands due to rapid physiological changes and requirements by the growing placenta and fetus. Inadequate stores or intake of micronutrients during pregnancy can have adverse effects on maternal and child health. Except for folate, little is known about the effects of deficiencies existing before pregnancy. Women in low‐ and middle‐income countries may enter pregnancy with multiple micronutrient deficiencies which could have irreversible effects on pregnancy outcomes by affecting critical developmental processes that begin very early in gestation. We aimed to examine micronutrient status and overall health in 100 prepregnant women living in Asesewa, Ghana (a semi‐rural area). Women were eligible if they reported an expectation to become pregnant within the next 6 months. Enrolled women participated in one visit at the regional hospital where they self‐reported health history and socio‐demographic characteristics and we measured blood pressure, height, weight, and hemoglobin. We collected an 8 mL venous blood sample. Serum and plasma were shipped to Penn State for analysis. Markers of iron status (iron, ferritin, total iron‐binding capacity) were measured in serum by ELISA and transferrin saturation (TSAT) was calculated. Zinc and copper were measured in plasma by flame atomic absorption spectrophotometry. Retinol was measured in serum by ultra‐high performance liquid chromatography. Women had a mean (SD) age of 26.5 (5.1) years, 10.2 (2.8) years of school, and BMI of 25.4 (5.3) kg/m 2 . Almost all women reported being in a committed relationship (96%) and 40% of women reported no previous pregnancies. Fifty‐four percent had a history of malaria, 15% reported previous night blindness, and only 2 women reported taking micronutrient supplements. Most women reported use of a latrine shared among more than one household and, over 90% of women had electricity and a mobile phone in their household. Twenty percent of households had food insecurity in the past month. For nutritional status, 39% of women were overweight or obese and 34% were anemic. Iron deficiency was seen in 10% (ferritin <12 μg/L and TSAT<16%) of the women, zinc deficiency in 15% (<70 μg/dL), copper deficiency in 9% (<80 μg/dL), and vitamin A deficiency in 7% (retinol <20 μg/dL). Forty‐one percent of women had one deficiency and 10% of women had two deficiencies. In a population of prepregnant women in Ghana, anemia was common and most women were deficient in one or more micronutrients. Micronutrient status should be given more attention among women who expect to become pregnant and future research should examine the impact on subsequent pregnancy outcomes for the mother and her offspring. Support or Funding Information Penn State Africana Research Center and other internal Penn State funding