The objective of the current analysis was to explore the association of multiple micronutrients with Hb concentration among pregnant women in a South Asian setting, a topic that has not been adequately explored.

Sociodemographic, anthropometric and micronutrient status (plasma ferritin, transferrin receptor, retinol, α- and γ-tocopherol, folate, vitamin B12, Zn) and Hb concentration were assessed at early pregnancy.

The biochemical sub-study was nested within a double-blind, placebo-controlled, community-based vitamin A and β-carotene supplementation trial in rural north-western Bangladesh (JiVitA). All assessments were conducted before trial supplementation was initiated.

A systematic sample of 285 women was selected from those enrolled in the biochemical sub-study.

Seventeen per cent of women were mildly anaemic; moderate and severe anaemia was uncommon (2·1 %). α-Tocopherol, vitamin B12 and Zn deficiencies were common (43·5 %, 19·7 % and 14·7 %, respectively); however, vitamin A, folate and Fe deficiencies were comparatively rare (7·4 %, 2·8 % and <1 %, respectively). Plasma Zn, vitamin B12 and α-tocopherol were positively associated and plasma γ-tocopherol was negatively associated with Hb (P < 0·05) after adjustment for gestational age, inflammation status, season and nutritional status measured by mid-upper arm circumference.

Among pregnant women in rural Bangladesh with minimal Fe deficiency, plasma Zn, vitamin B12, and α- and γ-tocopherol concentrations were associated with Hb concentration. Appreciating the influence on Hb of micronutrients in addition to those with known associations with anaemia, such as Fe, folate, and vitamin A, is important when addressing anaemia in similar settings.

To assess the nutritional status and risk factors of undernutrition in post-menarcheal girls in rural northern Bangladesh.

Cross-sectional data on anthropometric measurements, dietary intake, work activity, morbidity and socio-economic status were collected from 12- to 19-year-old primigravidae (n 209) and never-pregnant adolescents (n 456) matched on age and time since menarche. Multiple regression analyses were conducted to determine predictors of stunting, thinness, upper-arm muscle (UAMZ) and fat area Z-scores (UAFZ) among the adolescent girls.

A large proportion of adolescents (49 %) were stunted (height-for-age Z-score <−2) and underweight (40 %; weight-for-age Z-score <−2), but not thin (BMI-for-age <5th percentile; ∼10 %). The mean (sd) UAMZ and UAFZ of the adolescent girls was −0·3 (0·64) and −0·9 (0·40), respectively. Lean mass increased whereas fat mass declined with age. Both stunting and thinness were positively associated with age and time since menarche (P < 0·05). Young age (12–14 years) and literacy were protective against stunting among pregnant adolescents (OR = 0·29, 95 % CI 0·09, 0·88 and OR = 0·50, 95 % CI 0·26, 0·96, respectively). Having symptoms of diarrhoea or dysentery (OR = 7·40, 95 % CI 1·43, 38·29) predicted thinness and was associated with lower UAMZ and UAFZ among never-pregnant girls (both P < 0·05). Performing light-to-moderate activities was protective against thinness among never-pregnant girls (OR = 0·43, 95 % CI 0·22, 0·82), whereas pregnant adolescents who performed high levels of strenuous activities had greater UAMZ (P < 0·05).

Undernutrition was widespread among this post-menarcheal adolescent population. Younger and literate adolescents were less likely to be stunted, whereas thinness and body composition were associated with morbidity and work activity.