The iron status of rural Nigerian women in the second and third trimesters of pregnancy: implications for the iron endowment and subsequent dietary iron needs of their babies

Aim: The aim of the study was to determine the iron status of rural - dwelling pregnant Nigerian women in the second and third trimesters, and to predict their risk of giving birth to babies with sub-optimal iron endowment.
Method: This was a prospective cohort study conducted between April and August, 2021. A total of 174 consecutive and consenting pregnant rural-dwellers, who met the inclusion criteria, were recruited by convenience sampling from the ante-natal clinic of a public hospital in Nsukka, a semi-rural town in south-east Nigeria. The subjects were aged 21 - 40 years, and their iron status was determined by measuring the blood haemoglobin and serum ferritin levels. Haemoglobin was determined by the cyanmethemoglobin method while the serum ferritin level was determined by the enzyme immunoassay method.
Result: Almost half (47.7 %) of the subjects had haemoglobin concentrations below 11g/dl, while about two out of every five (40.8%) had ferritin levels <15 µg/l. The prevalence of ID, IDA and NIDA were 40.8%, 23.6% and 24.7%, respectively. The mean ferritin levels varied with maternal age, gestation stage, pregnancy intervals and the intake of iron supplements. The mean ferritin concentration was higher in the second trimester than the third. The mean ferritin level (37.10 ± 3.02 µg/l was higher in the group that took iron supplements than the group that did not (20.76 ± 2.11 µg/l). However, two out of five subjects in both groups had ferritin levels < 15.0 µg/l.
Conclusion: The prevalence of IDA was quite high amongst the subjects in both trimesters even with the widespread intake of the recommended oral iron supplements. About four out of ten of the subjects had ferritin levels of < 15 µg/l and were thus judged at risk of giving birth to babies with poor iron deposits. Therefore, more effective strategies are needed to monitor and prevent IDA among pregnant women in rural populations of Nigeria and, by inference, other parts of tropical Africa.