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Public Health Nutr. 2018 Aug;21(11):2046-2055. doi: 10.1017/S1368980018000459. Epub 2018 Mar 21.

Association between pre-pregnancy weight status and maternal micronutrient status in early pregnancy.

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1Department of Public Health,Amsterdam Public Health Research Institute,Academic Medical Center,University of Amsterdam,Postbox 22660,1100 DD Amsterdam,The Netherlands.
2Department of Health Sciences, Faculty of Earth & Life Sciences,Vrije Universiteit Amsterdam,Amsterdam Public Health Research Institute,Amsterdam,The Netherlands.
3Global Child Health Group,Amsterdam Institute of Global Health and Development,Amsterdam,The Netherlands.



Inadequate maternal micronutrient status during pregnancy can lead to short- and long-term health risks for mother and offspring. The present study investigated the association between pre-pregnancy weight status and micronutrient status during pregnancy.


Maternal blood samples were collected during early pregnancy (median 13, interquartile range 12-15 weeks) and were assayed for serum folate, ferritin, Fe and vitamin B12. Regression modelling was used to assess the association between pre-pregnancy underweight, normal weight, overweight and obesity, and micronutrient levels, as well as the odds for deficiencies.


The Amsterdam Born Children and their Development (ABCD) study, the Netherlands.


Women with singleton pregnancies without diabetes (n 4243).


After adjustment for covariates, overweight women and obese women had lower (β; 95 % CI) folate (-1·2; -2·2, -0·2 and -2·3; -4·0, -0·7 nmol/l, respectively) and Fe (-1·7; -2·3, -1·1 and -3·6; -4·7, -2·6 μmol/l, respectively) levels than women with normal weight. Furthermore, overweight women had 6 % (95 % CI -9, -3 %) and obese women had 15 % (-19, -10 %), lower vitamin B12 levels, and obese women had 19 % (6, 32 %) higher ferritin levels, than normal-weight women. Obese women had higher odds (OR; 95 % CI) for folate deficiency (2·03; 1·35, 3·06), Fe deficiency (3·26; 2·09, 5·08) and vitamin B12 deficiency (2·05; 1·41, 2·99) than women with normal weight. Underweight was not associated with micronutrient status.


During early pregnancy, women with pre-pregnancy overweight and obesity had lower serum folate, Fe and vitamin B12 status. This resulted in increased risk of serum folate, Fe and vitamin B12 deficiencies in women with obesity.


BMI; Micronutrient deficiency; Obesity; Pregnancy


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