title: Iron, folate and cobalamin deficiency in anaemic pregnant females in tertiary care centre at Rawalpindi.
abstract: BACKGROUND
  Anaemia in pregnancy is a common clinical problem contributing to increased maternal and foetal morbidity. This study was carried out to determine frequency of iron, folate and cobalamin deficiency and associated risk factors in the anaemic pregnant females who reported first time during second and third trimester for antenatal check-up in the tertiary care hospital at Rawalpindi.
  
  
  METHODS
  This case control study was carried out in a tertiary care hospital at Rawalpindi. Two hundred and fifty pregnant women (age: 19-43 years) consisting of 125 anaemic (Hb < 110 g/L) and 125 non-anaemic who reported first time at antenatal clinic were included. Data on socio-demographic characteristics, parity and dietary intake were collected. Complete blood counts were done. Serum ferritin, folate and cobalamin assays were performed by using DPC kits on Immulite-1000.
  
  
  RESULTS
  The pregnant women were categorised having mild (Hb up to 54%), moderate (Hb up to 36%), or severe (Hb up to 10%) anaemia during antennal visit. They had significantly lower median (range) levels of haemoglobin 96 (40-110) g/L, ferritin 8 (3-142) microg/L, folate 15 (3-54) etamol/L and cobalamin 171 (111-629) etamolL than controls (p = < 0.01). Micronutrient analysis revealed secondary pregnancy related deficiency of Iron (57%), folate (20%). combined iron and folate (19%) and cobalamin (4%) in the female Among the risk factors, low income (OR: 7.69), multiparty (OR: 2.93), lack of iron/folate supplementation (OR 2.91) and inadequate dietary intakes (OR 2.51) were associated with anaemia.
  
  
  CONCLUSIONS
  The pregnant anaemic women had iron (57%); folate (20%), followed by combined iron folate (19%) and cobalamin (4%) deficiency during first antenatal visit. Low income, multiparty, poor diet and lack of supplements are the main contributor in development of anaemia during pregnancy.
authors.affiliation: Department of Pathology, Army Medical College, National University of Sciences and Technology, Rawalpindi, Pakistan. dilshad56@yahoo.com
authors.forename: Dilshad Ahmed
authors.initials: DA
authors.lastname: Khan
authors.forename: Samia
authors.initials: S
authors.lastname: Fatima
authors.forename: Rabia
authors.initials: R
authors.lastname: Imran
authors.forename: Farooq Ahmad
authors.initials: FA
authors.lastname: Khan
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D005494:Folic Acid Deficiency / Q000453:epidemiology*; D006801:Humans; D000090463:Iron Deficiencies; D010154:Pakistan / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D012307:Risk Factors; D014806:Vitamin B 12 Deficiency / Q000453:epidemiology*