Programme no. 347-OP
Public Health
Ethnic Differences in Iron Deficiency and Anaemia in Pregnancy: A Population-Based Cohort Study
Anne Karen Jenum1, Marthe-Lise Næss-Andresen*2, Jens Petter Berg3
1Departement of General Pratice,Institute of Health and Society, University of Oslo,OSLO,Norway, 2Departement of General Pratice,Institute of Health and Society, University of Oslo,Oslo,Norway, 3Department of Medical Biochemistry,Institute of Clinical Medicine, University of Oslo,OSLO,Norway
* = Presenting author
Objectives: To explore ethnical differences in iron deficiency and anaemia in pregnant women.
Background: WHO estimates that most pregnant women in low- and middle income countries and 30 – 40% of pregnant women in high income countries are iron deficient. Global prevalence of anaemia in pregnant women is 38%, the highest occurrence is in South Asia (52%) and Central and West Africa (56%).

Iron deficiency and anaemia are associated with adverse health outcomes for mother and child, and WHO has set a target to reduce the anaemia rate by 50%, to 15% in 2025. The prevalence of iron deficiency anaemia among fertile women in Norway is reduced the last 5 decades, while the prevalence of iron deficiency remains high.

Results: Preliminary analyses revealed that the median value of ferritin in early pregnancy was twice as high among Western European women compared to ethnic minority women, and the prevalence of iron deficiency was three times higher among minority women. The mean value of haemoglobin was 0,4 g/dl lower among ethnic minority women, and the prevalence of anaemia was about three times higher among ethnic minority women compared to western women. The highest prevalence of both iron deficiency and anaemia was found among women from South Asia (50%/16%) and Africa (53%/19%). More results will be presented at The Nordic Congress of General Practice.
Material/Methods: A multi-ethnic cohort of healthy pregnant women attending primary antenatal care at three public Child Health Clinics, in Oslo, Norway. Primary outcome measures are serum ferritin and haemoglobin; we have additional data on iron status and are planning to analyse sTfR from the Biobank. 823 women (74% of invited) were included in the study, of which 59% were of ethnic minority origin. Mean gestational week of inclusion was 14 ±2 and 804 (98%) had valid ferritin and haemoglobin concentrations measured. Iron deficiency was defined as ferritin <15 mcg/L and anaemia as Hb <11 g/dL. Ethnic origin was defined by the participant's mother's country of birth.
Conclusion: We found large ethnic differences in the prevalence of iron deficiency and anaemia in Norway, with groups from South Asia and Africa at highest risk.
Points for discussion: There is no consensus in Europe as to whether iron status including ferritin, should be examined in early pregnancy, or whether iron supplementation should be routinely recommended. National guidelines differ and very few seem to reflect today’s multi-ethnic context in Europe. This study contributes information about iron status in a multi-ethnic group of pregnant women which may help to form new guidelines and to identify groups with particularly high prevalence of “at-risk” women.