Volume 86, Issue 1, July (2001), pp. 81-87 © The Author 2001

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Inter-pregnancy folate and iron status of women in an inner-city population

Wendy Doyle¹*, Aparna Srivastava², Michael A. Crawford¹, Rupinda Bhatti³, Zoé Brooke¹ and Kate L. Costeloe^2
1Institute of Brain Chemistry & Human Nutrition, University of North London, London N7 8DB, UK
²Department of Child Health, St Bartholomew's and the Royal London School of Medicine and Dentistry EC1A 7BE, UK
³Haematology Department, Homerton Hospital, London E9 6SR, UK

 (Received 10 August 2000–Revised 29 January 2001–Accepted 28 February 2001)

The purpose of the present study was to evaluate whether micronutrient supplementation improved the nutritional status of women with poor diets during the inter-pregnancy interval. Fifty-five women who had given birth to a low birth weight baby (<2·5 kg), and who planned to have a further pregnancy, were recruited to a prospective randomised study in East London, UK. Of the fifty-five mothers recruited, forty-four (78 %) met fewer than four of sixteen dietary reference values according to the information provided in a 7 d diet diary, and were categorised as having an ‘inadequate’ diet. Half of the mothers in the ‘inadequate’-diet group were randomly assigned to receive a micronutrient and a single cell oil supplement containing docosahexaenoic acid. All participants received dietary advice based on analysis of their diet diaries, and general lifestyle advice on preparing for pregnancy. Mothers had a blood sample taken at 3 and 9 months post-partum to measure their folate, Fe stores and fatty acid status. Mean serum and erythrocyte folate levels increased significantly between 3 and 9 months post-partum in both the adequate-diet group and the supplemented group. At 9 months post-partum, over half of the unsupplemented, inadequate-diet group remained severely deficient in folate (serum folate <230 nmol/l) and had low serum ferritin levels (<15 mg/l). The high prevalence of inadequate diets in this inner-city population and the low motivation of women to participate in a nutrition programme suggests that consideration should be given to the provision of free folate and Fe supplements to all women in this and similar populations, or at least to women who have delivered a low birth weight baby, who plan further pregnancies.

Keywords:
Folic acid: Iron: Pregnancy interval: Low birth weight