{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:02:19Z","timestamp":1775624539643,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","award":["43234896"],"award-info":[{"award-number":["43234896"]}],"id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Anemia is a major public health issue, particularly among women of reproductive age (WRA) in low- and middle-income countries (LMICs). Pakistan\u2019s National Nutrition Survey (NNS) 2011 showed a high prevalence of vitamin B12 (B12) and folate deficiency among WRA, necessitating further investigation in subsequent surveys. Methods: Blood samples from 31,828 WRA (15\u201349 years old) were collected using a stratified multi-stage sampling technique in NNS-2018. We conducted a secondary analysis using population-weighted logistic regression to assess the association of potential factors with B12 and folate deficiency. B12 (n = 4442) and folate (n = 12,662) samples were measured using an electrochemiluminescence immunoassay and a Centers for Disease Control and Prevention, USA (CDC)-approved microbiologic assay, respectively. Results: Folate deficiency was present in 44.7% WRA, and 20.2% had B12 deficiency. Provincial distribution was associated with folate deficiency, i.e., Sindh (OR = 1.140, 95% CI 1.018, 1.285), Baluchistan (OR = 1.237, 95% CI 1.052, 1.453), and Islamabad (OR = 1.524, 95% CI 1.109, 2.092), while B12 deficiency was prevalent in Islamabad (OR = 1.673, 95% CI 1.122, 2.497), Gilgit Baltistan (OR = 2.472, 95% CI 1.197, 5.106), and newly merged districts of KPK (OR = 1.584, 95% CI 0.977, 2.570). Rural residence (OR = 1.407, 95% CI 1.125, 1.760), obesity (OR = 1.649, 95% CI 1.282, 2.122), and overweight (OR = 1.560, 95% CI 1.262, 1.928) were associated with B12 deficiency. Conclusions: Our results show regional and demographic differences in the prevalence of folate and B12 deficiencies among WRA. This underscores the need for targeted nutritional interventions and further longitudinal studies to identify potentially associated factors.<\/jats:p>","DOI":"10.3390\/nu18071128","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T13:23:17Z","timestamp":1774963397000},"page":"1128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of Folate and Vitamin B12 Deficiencies in Women of Reproductive Age: Insights from the 2018 National Nutrition Survey of Pakistan"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5014-2176","authenticated-orcid":false,"given":"Junaid","family":"Iqbal","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"},{"name":"Center of Excellence for Women and Children, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1933-4313","authenticated-orcid":false,"given":"Kehkashan","family":"Begum","sequence":"additional","affiliation":[{"name":"Center of Excellence for Women and Children, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0752-9657","authenticated-orcid":false,"given":"Rabia","family":"Zuberi","sequence":"additional","affiliation":[{"name":"Center of Excellence for Women and Children, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3161-8116","authenticated-orcid":false,"given":"Muhammad","family":"Sajid","sequence":"additional","affiliation":[{"name":"Center of Excellence for Women and Children, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5326-3643","authenticated-orcid":false,"given":"Sidrah","family":"Nausheen","sequence":"additional","affiliation":[{"name":"Center of Excellence for Women and Children, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-3113","authenticated-orcid":false,"given":"Imran A.","family":"Chauhadry","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"},{"name":"Center of Excellence for Women and Children, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-8406","authenticated-orcid":false,"given":"Sajid Bashir","family":"Soofi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"},{"name":"Center of Excellence for Women and Children, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-599X","authenticated-orcid":false,"given":"Zulfiqar A.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Institute for Global Health & Development, Aga Khan University, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kumar, A., Kerketta, A., Dewali, S., Sharma, N., Kumari Panda, A., and Singh Bisht, S. 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