Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania

Christentze Schmiegelow; Omari Abdul Msemo; Sofie Lykke Møller; Birgitte Bruun Nielsen; Cecilie Bøge Paulsen; Lars Ødum; Thor Grundtvig Theander; Reginald Adolph Kavishe; John Peter Andrea Lusingu; Daniel Thomas Minja; Ib Christian Bygbjerg

doi:10.1111/tmi.13219

Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania

Christentze Schmiegelow^*, Omari Abdul Msemo, Sofie Lykke Møller, Birgitte Bruun Nielsen, Cecilie Bøge Paulsen, Lars Ødum, Thor Grundtvig Theander, Reginald Adolph Kavishe, John Peter Andrea Lusingu, Daniel Thomas Minja, Ib Christian Bygbjerg

^*Corresponding author for this work

1 Citation (Scopus)

Abstract

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.

Original language	English
Journal	Tropical Medicine and International Health
Volume	24
Issue number	5
Pages (from-to)	596-607
Number of pages	12
ISSN	1360-2276
DOIs	https://doi.org/10.1111/tmi.13219
Publication status	Published - May 2019

Keywords

anthropometry
haemoglobin
low-and middle-income countries
preconception and early pregnancy
red blood cell morphology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Schmiegelow, C., Msemo, O. A., Møller, S. L., Nielsen, B. B., Paulsen, C. B., Ødum, L., Theander, T. G., Kavishe, R. A., Lusingu, J. P. A., Minja, D. T., & Bygbjerg, I. C. (2019). Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania. Tropical Medicine and International Health, 24(5), 596-607. https://doi.org/10.1111/tmi.13219

Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania. / Schmiegelow, Christentze; Msemo, Omari Abdul; Møller, Sofie Lykke et al.
In: Tropical Medicine and International Health, Vol. 24, No. 5, 05.2019, p. 596-607.

Research output: Contribution to journal › Journal article › Research › peer-review

Schmiegelow, C, Msemo, OA, Møller, SL, Nielsen, BB, Paulsen, CB, Ødum, L, Theander, TG, Kavishe, RA, Lusingu, JPA, Minja, DT & Bygbjerg, IC 2019, 'Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania', Tropical Medicine and International Health, vol. 24, no. 5, pp. 596-607. https://doi.org/10.1111/tmi.13219

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title = "Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania",

abstract = "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.",

keywords = "anthropometry, haemoglobin, low-and middle-income countries, preconception and early pregnancy, red blood cell morphology",

author = "Christentze Schmiegelow and Msemo, {Omari Abdul} and M{\o}ller, {Sofie Lykke} and Nielsen, {Birgitte Bruun} and Paulsen, {Cecilie B{\o}ge} and Lars {\O}dum and Theander, {Thor Grundtvig} and Kavishe, {Reginald Adolph} and Lusingu, {John Peter Andrea} and Minja, {Daniel Thomas} and Bygbjerg, {Ib Christian}",

year = "2019",

month = may,

doi = "10.1111/tmi.13219",

language = "English",

volume = "24",

pages = "596--607",

journal = "Tropical Medicine and International Health",

issn = "1360-2276",

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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 and International Health

JF - Tropical Medicine and International Health

IS - 5

ER -

Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania

Abstract

Keywords

UN SDGs

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