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Determinants of Folate and Vitamin B 12 Deficiencies in Women of Reproductive Age: Insights from the 2018 National Nutrition Survey of Pakistan
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Determinants of Folate and Vitamin B 12 Deficiencies in Women of Reproductive Age: Insights from the 2018 National Nutrition Survey of Pakistan
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Journal Article
Determinants of Folate and Vitamin B 12 Deficiencies in Women of Reproductive Age: Insights from the 2018 National Nutrition Survey of Pakistan
2026
Overview
Anemia is a major public health issue, particularly among women of reproductive age (WRA) in low- and middle-income countries (LMICs). Pakistan's National Nutrition Survey (NNS) 2011 showed a high prevalence of vitamin B
(B
) and folate deficiency among WRA, necessitating further investigation in subsequent surveys.
Blood samples from 31,828 WRA (15-49 years old) were collected using a stratified multi-stage sampling technique in NNS-2018. We conducted a secondary analysis using population-weighted logistic regression to assess the association of potential factors with B
and folate deficiency. B
(
= 4442) and folate (
= 12,662) samples were measured using an electrochemiluminescence immunoassay and a Centers for Disease Control and Prevention, USA (CDC)-approved microbiologic assay, respectively.
Folate deficiency was present in 44.7% WRA, and 20.2% had B
deficiency. Provincial distribution was associated with folate deficiency, i.e., Sindh (OR = 1.140, 95% CI 1.018, 1.285), Baluchistan (OR = 1.237, 95% CI 1.052, 1.453), and Islamabad (OR = 1.524, 95% CI 1.109, 2.092), while B
deficiency was prevalent in Islamabad (OR = 1.673, 95% CI 1.122, 2.497), Gilgit Baltistan (OR = 2.472, 95% CI 1.197, 5.106), and newly merged districts of KPK (OR = 1.584, 95% CI 0.977, 2.570). Rural residence (OR = 1.407, 95% CI 1.125, 1.760), obesity (OR = 1.649, 95% CI 1.282, 2.122), and overweight (OR = 1.560, 95% CI 1.262, 1.928) were associated with B
deficiency.
Our results show regional and demographic differences in the prevalence of folate and B
deficiencies among WRA. This underscores the need for targeted nutritional interventions and further longitudinal studies to identify potentially associated factors.
