TY - JOUR
T1 - Preconceptional factors associated with haemoglobin concentration in early pregnancy
T2 - a community-based cohort study in rural northeastern Tanzania
AU - Schmiegelow, Christentze
AU - Msemo, Omari Abdul
AU - Møller, Sofie Lykke
AU - Nielsen, Birgitte Bruun
AU - Paulsen, Cecilie Bøge
AU - Ødum, Lars
AU - Theander, Thor Grundtvig
AU - Kavishe, Reginald Adolph
AU - Lusingu, John Peter Andrea
AU - Minja, Daniel Thomas
AU - Bygbjerg, Ib Christian
PY - 2019/5
Y1 - 2019/5
N2 - Objective: Maternal anaemia in early pregnancy is associated with poor pregnancy outcomes. Furthermore, preconceptional health can influence the health during pregnancy. The aim of this study was to investigate which preconceptional factors were associated with haemoglobin (Hb) concentration in early pregnancy. Methods: In Tanzania, 226 women were followed at preconception and during early pregnancy. Red blood cell (RBC) morphology, serum micronutrient concentration, demographic characteristics and health status were assessed in preconception and in early pregnancy. The association between preconceptional factors and Hb concentration in early pregnancy was investigated using simple and multiple linear regression analyses stratified by preconceptional anaemia status. Results: Mean Hb was 123 and 119 g/l before conception and during early pregnancy (median gestational age 53 days) respectively. Preconceptional mid-upper arm circumference (MUAC) (adjusted coefficient (AC) 0.35 95% CI 0.9–0.61) and preconceptional Hb concentration (AC 0.45 95% CI 0.36–0.54) were positively associated with early pregnancy Hb concentration, whereas preconceptional microcytic hypochromic RBC morphology (AC −6.00 95% CI −9.56 to −2.44) was negatively associated with early pregnancy Hb concentration. In addition, treatment of preconceptional malaria was positively associated with early pregnancy Hb concentration (AC 6.45 95% CI 0.74–12.2) among women with preconceptional anaemia. In contrast, among preconceptional non-anaemic women, only preconceptional Hb concentration and medium socio-economic status was positively associated with early pregnancy Hb concentration. Conclusions: Mid-upper arm circumference (MUAC) and Hb measurements in preconception can help to detect women at increased risk of low Hb concentration in early pregnancy.
AB - Objective: Maternal anaemia in early pregnancy is associated with poor pregnancy outcomes. Furthermore, preconceptional health can influence the health during pregnancy. The aim of this study was to investigate which preconceptional factors were associated with haemoglobin (Hb) concentration in early pregnancy. Methods: In Tanzania, 226 women were followed at preconception and during early pregnancy. Red blood cell (RBC) morphology, serum micronutrient concentration, demographic characteristics and health status were assessed in preconception and in early pregnancy. The association between preconceptional factors and Hb concentration in early pregnancy was investigated using simple and multiple linear regression analyses stratified by preconceptional anaemia status. Results: Mean Hb was 123 and 119 g/l before conception and during early pregnancy (median gestational age 53 days) respectively. Preconceptional mid-upper arm circumference (MUAC) (adjusted coefficient (AC) 0.35 95% CI 0.9–0.61) and preconceptional Hb concentration (AC 0.45 95% CI 0.36–0.54) were positively associated with early pregnancy Hb concentration, whereas preconceptional microcytic hypochromic RBC morphology (AC −6.00 95% CI −9.56 to −2.44) was negatively associated with early pregnancy Hb concentration. In addition, treatment of preconceptional malaria was positively associated with early pregnancy Hb concentration (AC 6.45 95% CI 0.74–12.2) among women with preconceptional anaemia. In contrast, among preconceptional non-anaemic women, only preconceptional Hb concentration and medium socio-economic status was positively associated with early pregnancy Hb concentration. Conclusions: Mid-upper arm circumference (MUAC) and Hb measurements in preconception can help to detect women at increased risk of low Hb concentration in early pregnancy.
KW - anthropometry
KW - haemoglobin
KW - low-and middle-income countries
KW - preconception and early pregnancy
KW - red blood cell morphology
U2 - 10.1111/tmi.13219
DO - 10.1111/tmi.13219
M3 - Journal article
C2 - 30767358
AN - SCOPUS:85062501770
SN - 1360-2276
VL - 24
SP - 596
EP - 607
JO - Tropical Medicine & International Health
JF - Tropical Medicine & International Health
IS - 5
ER -