212472 Iron consumed through groundwater is associated with iron status of women of reproductive age in rural Bangladesh

Tuesday, November 10, 2009

Rebecca D. Merrill, MHS , Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Abu Ahmed Shamim , JiVitA Project, Rangpur, Bangladesh
Alain B. Labrique, PhD , Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Parul Christian, DrPH , Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Keith P. West, DrPH , Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Rates of iron deficiency (ID, plasma ferritin < 12 g/l) and resultant anemia (IDA, ID plus low Hb) were very low among women of reproductive age (n=1198) participating in a field trial in rural Bangladesh from 2002 2006, both being < 7% at 1st and 3rd trimester and 3 months postpartum assessments. Intakes of iron sources (heme foods and supplements) were infrequent suggesting consumption of unconventional iron sources was enabling the maintenance of sufficient iron stores through pregnancy and lactation.

Methods: In 2008 during 2 follow-up examinations, 287 participants randomly selected from the original field trial were re-visited to explore the influence of exposure to groundwater, as a source of iron, on chronic iron status.

Results: Heme and iron supplement intake remained low (meat, fish, and poultry intakes (median (IQR)): 5 (3-9) times/wk, any supplement use ≤ 4% of participants). Iron deficiency was non-existent (n=222, median (IQR) plasma ferritin (g/L) at follow-up: 66.8 (41.8, 100.4), 0% ID and IDA). Accounting for tubewell iron concentration (median (IQR): 16.5 mg/L (7.2, 28.3)) and daily tubewell water consumption (median (IQR): 2.6 L/day (2.1, 3.3)), participants (n=278) chronically consumed 42.3 mg iron/day (17.8, 71.8) through drinking water. Current iron status was significantly associated with amount of iron consumed daily through drinking groundwater (n=214, Spearman rho=0.34, p value<0.00).

Discussion: Natural groundwater iron consumed through drinking may provide a sustainable dietary source of iron. Funded by The Bill and Melinda Gates Foundation, Procter and Gamble, Inc, and USAID.

Learning Objectives:
Describe the association between consumption of iron through drinking groundwater and iron status of women of reproductive age in rural Bangladesh.

Keywords: Maternal Health, Water

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed the data collection and analysis as part of my dissertation research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.