Assessment of RBC-folate level and other determinant factors of neural tube defect among first trimester pregnant women who attends ante natal care in Lideta and T/haimanot health centers, Addis Ababa, Ethiopia.
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Date
2018-08
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Addis Ababa Universty
Abstract
Background: Folate is an essential vitamin for de novo DNA synthesis and cell proliferation. Deficiency of this vitamin during first trimester pregnancy is associated with unintended pregnancy and birth outcomes, particularly neural tube defects. Objective: The aim of this study was to assess folate status, and other determinant factors of neural tube defect among first trimester pregnant women who were attending antenatal care in Lideta and T/haimanot health centers, Addis Ababa, Ethiopia. Materials and methods: Institutional based cross-sectional study was conducted from August 8, 2017 to January 3, 2018 at Lideta and T/haimanote health centers. For this study, 160 participants were enrolled via convenience sampling method. Red blood cell folate was measured by electrochemiluminescence binding assay method and MCV was measured by Beckman coulter method. Data were entered in to Epi-Data version 3.1 and analyzed by SPSS version 22.0. Descriptive statistics was used to describe demographic characteristics and to determine magnitude of folate deficiency. Logistic regression was used to identify risk factors of folate deficiency. P-value of < 0.05 was considered as statistically significant. Results: In the present study, 44/160 (27%) participants had RBC folate level < 400ng/mL, insufficient to prevent neural tube defect. The magnitude of macrocytosis was 2.4% among 82 participants. Besides, only 13/160 (8.1%) participants found to have information about folate and five of them correctly know the timing of folic acid supplementation. The prevalence of folate supplementation during the first trimester was also only two/one hundred sixty (1.3%). Bivariate regression shows income as a determinant factor for folate deficiency (p value = 0.01). Regular consumption of fruit (OR: 0.44, CI: 0.21-0.89), vegetable (OR: 0.38, CI: 0.71-2.29) and milk (OR: 0.47, CI: 0.23-.96) were found to lower the possibility of getting folate deficiency by the bivariate regression. But, regular vegetable intake was the only continued determinant factor by the multivariate regression (adjusted OR: 0.41, CI: 0.18-0.93). Conclusion: This study established that 27.5% of the first trimester pregnant women had a folate status insufficient to prevent neural tube defect. Furthermore, folic acid usage among the first trimester pregnant women was very low. This study also identified that regular consumption of leafy green vegetable as an independent factor to overcome folate deficiency.
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Folate Metabolism, Folate Deficiency, Pregnant Women, Determinant Factors, Neural Tube Defect