• Saqib Malik Medicine, ATH, Atd
  • Zainab Syed Medicine, ATH, Atd
  • Farhat Naz Medicine, ATH, Atd
  • Najma Rehman
  • Sadia Rehman Medicine, ATH, Atd
  • Talha Durrani Medicine, ATH, Atd



folic acid deficiency, women of child bearing age.


Background: Folic acid deficiency is one of the most common deficiencies among women of childbearing age. It can lead to neural tube defects, a significant cause of disability and mortality among infants. Therefore, the main objective of this study was to determine a folic acid deficiency in women of childbearing age in Ayub Teaching Institute, Abbottabad Methods: This cross-sectional study was carried out in Ayub Teaching Institute, Abbottabad from  January 2020 to June  2020. In this study, a total of 193 women of childbearing age were included through consecutive sampling. Results:  In this study 193 women of childbearing age were included. Mean age was 30±4.87 years. Out of 193 patients, 56.7% were found to be anemic and 38.9%were found to have folic acid deficiency. Conclusion:  Our study concludes that the majority of women of child bearing age are anemic in our set up. Moreover, the frequency of folic acid deficiency is 38.9 % which is high.  


Darnton-Hill I, Mkparu UC. Micronutrients in pregnancy in low- and middle-income countries. Nutrients 2015;7(3):1744–68.

Bailey RL, West KP Jr, Black RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metab 2015;66(Suppl 2):22–33.

Nasri K, Ben Fradj MK, Touati A, Aloui M, Ben Jemaa N, Masmoudi A, et al. Association of maternal homocysteine and vitamins status with the risk of neural tube defects in Tunisia: A case-control study. Birth Defects Res A Clin Mol Teratol 2015;103(12):1011–20.

Chandyo RK, Ulak M, Sommerfelt H, Schneede J, Ueland PM, Strand TA. Nutritional Intake and Status of Cobalamin and Folate among Non-Pregnant Women of Reproductive Age in Bhaktapur, Nepal. Nutrients 2016;8(6):375.

Chang JYF, Wang YP, Wu YC, Cheng SJ, Chen HM, Sun A. Hematinic deficiencies and anemia statuses in oral mucosal disease patients with folic acid deficiency. J Formos Med Assoc 2015;114(9):806–12.

Bailey LB, Hausman DB. Folate status in women of reproductive age as basis of neural tube defect risk assessment. Ann N Y Acad Sci 2018;1414(1):82–95.

Czeizel AE, Dudás I, Paput L, Bánhidy F. Prevention of neural-tube defects with periconceptional folic acid, methylfolate, or multivitamins? Ann Nutr Metab 2011;58(4):263–71.

WHO. Serum and red blood cell folate concentrations for assessing folate status in populations [Internet]. World Health Organization 2015 [cited 2017 Sep 22]. Available from:

Al Rakaf MS, Kurdi AM, Ammari AN, Al Hashem AM, Shoukri MM, Garne E, et al. Patterns of folic acid use in pregnant Saudi women and prevalence of neural tube defects Results from a nested case-control study. Prev Med Rep 2015;2:572–6.

Tawfik AA, Hanna ET, Freig SA. Folate status in Egypt. IOSR J Nurs Health Sci 2014;3(2):32–6.

Rosenthal J, Lopez-Pazos E, Dowling NF, Pfeiffer CM, Mulinare J, Vellozzi C, et al. Folate and Vitamin B12 Deficiency Among Non-pregnant Women of Childbearing-Age in Guatemala 2009-2010: Prevalence and Identification of Vulnerable Populations. Matern Child Health J 2015;19(10):2272–85.

Tinker SC, Hamner HC, Qi YP, Crider KS. U.S. women of childbearing age who are at possible increased risk of a neural tube defect-affected pregnancy due to suboptimal red blood cell folate concentrations, National Health and Nutrition Examination Survey 2007 to 2012. Birth Defects Res A Clin Mol Teratol 2015;103(6):517–26.

Hamedani P, Hashmi KZ, Manji M. Iron depletion and anaemia: prevalence, consequences, diagnostic and therapeutic implications in a developing Pakistani population. Curr Med Res Opin 1987;10(7):480–5.

de Benoist B. Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull 2008;29(2_suppl1):S238–44.

Haidar J, Melaku U, Pobocik RS. Folate deficiency in women of reproductive age in nine administrative regions of Ethiopia: an emerging public health problem. South Afr J Clin Nutr 2010;23(3):132–7.

Abdollahi Z, Elmadfa I, Djazayeri A, Sadeghian S, Freisling H, Mazandarani FS, et al. Folate, vitamin B12 and homocysteine status in women of childbearing age: baseline data of folic acid wheat flour fortification in Iran. Ann Nutr Metabol 2008;53(2):143–50.

Luo ZX, Liu EM, Luo J, Li FR, Li SB, Zeng FQ, et al. Vitamin A deficiency and wheezing. World J Pediatr 2010;6(1):81–4.

Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health 2013;1(1):e16–25.

Duffy ME, Hoey L, Hughes CF, Strain JJ, Rankin A, Souverein OW, et al. Biomarker responses to folic acid intervention in healthy adults: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2013;99(1):96–106.

Ho CH, Yuan CC, Yeh SH. Serum folate levels in normal full-term pregnant Chinese women. Acta Obstet Gynecol Scand 1988;67(5):417–20.

Castilla EE, da Graça Dutra M, Lopez-Camelo JS, Rittler M, Orioli IM. Awareness of the Benefit of Periconceptional Folic Acid Supplementation in South America. Public Health Genomics 2000;3(2):71–6.

Kinnunen TI, Sletner L, Sommer C, Post MC, Jenum AK. Ethnic differences in folic acid supplement use in a population-based cohort of pregnant women in Norway. BMC Pregnancy Childbirth 2017;17(1):143.

Oner N, Vatansever U, Karasalihoğlu S, Ekuklu G, Celtik C, Biner B. The prevalence of folic acid deficiency among adolescent girls living in Edirne, Turkey. J Adolesc Health 2006;38(5):599–606.

McLennan J. Limited Reduction in Anemia in Children in a Low-Income Community Offered Iron Treatment Despite a Quality Improvement Initiative. J Health Care Poor Underserved 2021;32(1):191–203.

Kancherla V, Chadha M, Rowe L, Thompson A, Jain S, Walters D, et al. Reducing the Burden of Anemia and Neural Tube Defects in Low- and Middle-Income Countries: An Analysis to Identify Countries with an Immediate Potential to Benefit from Large-Scale Mandatory Fortification of Wheat Flour and Rice. Nutrients 2021;13(1):244.

Assaf S, Juan C. Stunting and Anemia in Children from Urban Poor Environments in 28 Low and Middle-income Countries: A Meta-analysis of Demographic and Health Survey Data. Nutrients 2020;12(11):3539.