Abstract
Background. To test the hypothesis that iron deficiency is more common among pregnant Pakistani than pregnant Norwegian women in Oslo; and to determine whether differences in the diet can explain some of the differences in stored iron.
Methods. A cross sectional study in the 18th week of pregnancy. Thirty-eight Pakistani women and 38 Norwegian women referred to routine ultrasound examination at Aker and Ullevål Hospitals in Oslo participated. Analysis was undertaken of phytate (inositol hexaphosphate) and its degradation products in bread and chapatti.
Results. Twenty-six (68%) of the Pakistani and six (17%) of the Norwegian women had ferritin levels below 12 ug/1 and a highly significant difference in serum ferritin was found between the groups (p<0.001). Only one of the Pakistani and seven of the Norwegian women were supplemented with iron and there were no significant differences in the dietary intake of hem iron, non-hem iron, organic fiber, tea, ascorbic acid, meat or cereals. The content of inositol hexaphosphate (phytate) and inositol pentaphosphate, well known inhibitors of iron absorption, were measured in bread and chapatti and the estimated dietary intake was much higher in the Pakistani group, mean (95% CI) was 1175 umol/day (933-1417) and 507 umol/day (417-597) respectively, p<0.001.
Conclusions. Iron deficiency seems to be far more common among pregnant Pakistanis in Norway than among pregnant Norwegians. We speculate that the main reasons for this are a combination of a higher parity and a less common use of iron supplementation in pregnancy in the Pakistani group, and a higher content of phytate in the Pakistani diet.