Prevalence and Risk Factors for Micronutrient Deficiencies During Pregnancy in Cayenne, French Guiana

Study Overview
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Brief Summary
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Micronutrient deficiencies are frequent in pregnant women in French Guiana, a French territory in South America. Micronutrient deficiencies are more frequent in precarious women. Obesity is a frequent problem but it is also associated with micronutrient deficiency. Micronutrient deficiencies have largely been overlooked in this outermost European region and should be corrected.

Detailed Description
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Involved in physical and brain development, immunity and metabolism, micronutrients have profound health effects. The nutritional status of pregnant women is a major determinant of fetal health. French Guiana has a rapid population growth. Social inequalities, cultural practices and gastrointestinal nematode infections in French Guiana could affect the prevalence of these deficiencies. The main objective of the present study was to estimate the prevalence of micronutrient deficiency among pregnant women in French Guiana. The secondary objective was to identify socio-demographic, dietary, obstetrical and neonatal risk factors associated with deficiencies. Pregnant women over 22 weeks of pregnancy hospitalized for delivery at the Obstetrical Emergency Department of the Hospital Center in Cayenne from May 2018 to March 2019 were included. A socio-demographic and food questionnaire was administered. Medical data were collected from the medical records. Blood and urine samples were taken. The descriptive analysis used Student and Chi2 tests. A total of 341 women were included. The majority were born in Haiti (39%) and French Guiana (34%). At least one micronutrient deficiency was observed in 81% of women. Precarious women had a significantly greater risk of micronutrient deficiency during pregnancy compared to those with both normal and complementary health insurance. Micronutrient deficiencies in pregnant women in French Guiana are a public health problem, a fact that was previously overlooked in a context of rising obesity. With over half of women overweight or obese and 81% with at least 1 micronutrient deficiency, balanced nutrition should be a major focus.

Official Title
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Prevalence of Micro-nutritional Deficiencies in Pregnant Women Presenting to the Emergency Department for Threatened Delivery

Conditions
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Deficiency; Diet, Pregnancy

Intervention / Treatment
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* Other: Observational only


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant at least 22 weeks of amenorrhea (WHO threshold for fetal viability) Patient hospitalized for delivery in the Gynecological and Obstetrical Emergency Unit at Cayenne hospital Patient's consent Consent of the legal representative if the patient is a minor Exclusion Criteria: Refusalto participate in the study. Being under guardianship or curatorship Having been previously enrolled in the study
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Observational only|The investigator collected the patient's data from the medical record and interviewed the patient to complete the nutritional questionnaire. The required biological, blood and urine samples were collected during routine blood sampling upon entry and hospitalization.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identification of a micronutrient deficiency defined as at least one micronutrient below the lower limit. | urinary iodine < 100 µg/L blood zinc level < 70 µg/dL magnesium < 0.75 mmol/L serum retinol < 0.70 µmol/L erythrocyte folate < 305 nmol/L blood cobalamin level < 150 pmol/L Martial status: ferritin < 20 µg/L; serum iron < 15 µg/L; iron saturation coefficient of transferrin < 16%. | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sociodemographic information | Socio-demographic and dietary risk factors associated with micronutrient deficiencies were investigated using a structured questionnaire. | 1 day | 
| assessment of Food diversity score | The food diversity score was inspired by the Food and Agriculture Organization's reports was assessed through a 24h recall, and calculated by adding the number of unique food groups consumed during last 24 hours. | 1 day | 
| Obstetrical and neonatal outcomes | Obstetrical and neonatal pathologies associated with micronutrient deficiencies were studied throughpatient interrogation and by analyzing medical records: rate of preeclampsia | 1 day | 
| Newborn health status | Gestational age at delivery, mode of delivery, weight, height, height, head circumference, APGAR, pathologies diagnosed on clinical examination before the 8th day of life | 1 day | 
| Mother Health status | Weight before pregnancy and on the day of inclusion, height, gestational age, pregnancy follow-up, microcytic anemia (hemoglobinemia <110 g/L, GMV >80 fl), primary hypothyroidism (increased TSH), gynaecological-obstetrical history, personal history of goiter or dysthyroidism, history of night blindness, personal history of anemia, other chronic conditions, history of digestive disorder/parasitoses, malaria history, drug treatment before and during pregnancy, micronutrient supplementation before and during pregnancy, tobacco use during pregnancy, alcohol use during pregnancy | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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micronutrients, risks factors, social inequalities