(P27-022-25) Biochemical Status of Multiple Concurrent Micronutrients in Pregnant Adults Across Seven U.S. States: Findings From an Observational Cross-Sectional Study

Objectives: Previous reports of prenatal micronutrient status have mainly focused on individual nutrient deficiencies, with less emphasis on concurrent nutrient insufficiencies. The present study examined the proportion of pregnant women with low biochemical status in multiple micronutrients and relationships between aggregated low nutrient status and maternal characteristics.

Methods: Data were derived from an observational cross-sectional study which analyzed serum nutrient biomarkers in adult pregnant women (24-34 weeks) taking a folic acid-containing prenatal vitamin (FAPV), across 7 US states. Low or deficient serum status data for vitamins A ( < 20.0 mcg/dL, < 40.8 mcg/dL), B2 ( < 5.6 mcg/L), B6 ( < 5 ng/mL), folate ( < 3 ng/mL), B12 ( < 201 pg/mL, < 232 pg/mL), C ( < 0.2 mg/dL), D ( < 20 ng/mL, < 40 ng/mL), zinc ( < 0.5 mcg/mL), and selenium ( < 109.8 ng/mL) were aggregated to examine the burden of low status in 1 or more micronutrients in the study sample (n=212). We explored associations between aggregated low status (categorical: low in 0, 1,  or ≥ 2 nutrients) and maternal characteristics, including demographic, pregnancy stage, and FAPV timing factors.

Results: No woman had low serum folate < 3 ng/mL. 94% of pregnant women had low status in ≥ 1 nutrient, when low nutrient status was assessed on least conservative thresholds. Notably, 81% of women had low status in ≥ 2 nutrients. Aggregated low status in micronutrients was associated with race/ethnicity (p=0.0075), education level (p=0.0067), and initiation timing of FAPV (p=0.0002). A higher proportion of women with low status in ≥ 2 nutrients was found among those who identified as a race/ethnicity other than white-only (89% vs 72% of those identifying as white-only), attained less than a college degree (95% vs 76% of those with a college degree or higher), and started FAPV between 3 months preconception and post-conception (87% vs 62% of those starting FAPV ≥ 4 months preconception). When concurrent low status was assessed on conservative thresholds, 88% of pregnant women had low status in ≥ 1 nutrient; and aggregated low micronutrient status remained associated with initiation timing of FAPV (p=0.0017).

Conclusions: In this study population, we found that most pregnant women taking a FAPV presented with low serum status in one or more nutrients assessed.

Funding Sources: This work was funded by Needed PBC and Rise Together Ventures.