Prevalence of iron and folic acid deficiency, the effectiveness of correction in women of early reproductive age: a prospective cohort study

Introduction. Iron deficiency conditions and folate insufficiency are highly prevalent among women of reproductive age in the Russian Federation and may adversely affect menstrual and reproductive function. Regional prevalence patterns and the effectiveness of combined correction for such deficiencies in the Republic of Bashkortostan remained understudied.

Aim: to assess the prevalence of iron and folic acid deficiency, associated dietary and gynecological risk factors, as well as the effectiveness of 3-month combined therapy with ferrous fumarate and folic acid in women of early reproductive age.

Materials and Methods. A prospective cohort study was conducted involving 372 women aged 20–25 years residing in the Republic of Bashkortostan. Actual nutrition was assessed (My Healthy Diet software), and menstrual blood loss was evaluated using the Mansfield–Voda–Jorgensen scale. Serum levels of ferritin, serum iron, total iron-binding capacity (TIBC), transferrin, transferrin iron saturation coefficient (TIS), folic acid, as well as complete blood count were measured. Women with iron deficiency received combined therapy – 163.56 mg ferrous fumarate (equivalent to 50 mg iron) + 540 µg folic acid (equivalent to 500 µg dry matter) for 3 months.

Results. Latent iron deficiency (ferritin < 15 µg/L) was detected in 34.4 %; 28.5 % had early latent iron deficiency (ferritin = 15 µg/L and changes in other ferrokinetic markers: decreased serum iron, TIS or increased transferrin and TIBC); the overall prevalence of iron deficiency signs was in 62.9 %. Manifest iron deficiency anemia (hemoglobin < 120 g/L) was detected in 27.4 %, folic acid deficiency (< 3 ng/mL) – in 23.7 %, and probable deficiency (3.0–5.9 ng/mL) – in 31.5 % of women. Inadequate iron intake (< 18 mg/day) was observed in 83.9 % of participants. Iron deficiency was associated with menorrhagia, abnormal uterine bleeding, and premenstrual syndrome. After 3 months of therapy, hemoglobin normalization was achieved in 95.2 %, ferritin normalization in 84.7 %, and serum folate normalization in 100,0 % of re-examined patients.

Conclusion. High prevalence of iron and folic acid deficiency associated with menstrual disorders and poor nutrition was found in women of early reproductive age in the Republic of Bashkortostan. Three-month combined therapy with ferrous fumarate and folic acid demonstrated high clinical and laboratory effectiveness.

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