The prevalence of anemia during pregnancy and its correlates vary by trimester and hemoglobin assessment method in Eastern Maharashtra, India

Datos Bibliográficos

ID15536643
AutoresLindsey M Locks (0000-0002-0019-9545, Boston University, autor de correspondencia), Shilpa Bhaise (Lata Medical Research Foundation), Varsha S Dhurde (0000-0002-8333-4975, Lata Medical Research Foundation), Abigail Gugel (Boston University), Jacqueline M Lauer (0000-0001-8434-6583, Boston University), Miloni Shah (0000-0001-8624-7845, Boston University), Aboli Goghari (Boston University), Patricia L Hibberd (0000-0002-7455-8117, Boston University), Archana Patel (0000-0002-2558-7421, Lata Medical Research Foundation)
Año2024
Volumen20
Número4
Páginase13684-e13684
Fecha de publicación2024-06-28
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaMaternal and Child Nutrition (JOURNAL)
Identificadores de la revistaISSN: 1740-8695 • E-ISSN: 1740-8709
EditorialWiley (PUBLISHER • GB)
DOI10.1111/mcn.13684
PMID38943254
OpenAlexW4400158593
IdiomaEN
Citas recibidas1
Referencias citadas8

Approximately half of pregnant women in India are anemic, representing over 7.5 million women. Few studies have assessed the relationship between multiple micronutrient deficiencies and anemia during pregnancy or the trajectory of hemoglobin (Hb) during pregnancy in low-resource settings. We enrolled 200 pregnant women from the Maternal and Newborn Health (MNH) registry, a population-based pregnancy and birth registry in Eastern Maharashtra, India to address these gaps. The women provided capillary (finger-prick) and venous blood specimens at enrollment ( 27 weeks). Capillary specimens were analyzed at the time of collection with a HemoCue Hb 201+; venous specimens were shipped on dry ice to a laboratory for cyanmethemoglobin assessment. In the 1st trimester, mean Hb concentration and anemia (Hb 12 and folate deficiencies were 40%, 30% and 0%, respectively. Among women with anemia in the 1st trimester (venous blood), 56% had concurrent iron deficiency (inflammation-adjusted serum ferritin <15 μg/L) indicating that their anemia may be amenable to iron supplementation. In total, 21% of women had ID and anemia, 19% ID in the absence of anemia, 16.5% anemia in the absence of ID and 43.5% had neither. By the 3rd trimester, mean Hb from capillary specimens had declined to 10.1 ± 1.35 g/dL and anemia prevalence increased to 70.7%, despite 99.4% mothers reporting receipt of iron-folic acid (IFA) supplements during her current pregnancy, and 83.9% reporting IFA consumption the previous day. Significant predictors of anemia in the 1st trimester (both venous and capillary) included the number of weeks gestation at the time of Hb assessment and inflammation-adjusted serum ferritin. For 3rd trimester anemia, significant predictors included 1st trimester height, BMI and IFA consumption during the 3rd trimester (but not 1st trimester micronutrient biomarkers), indicating that IFA supplementation over the course of pregnancy may have influenced micronutrient status and anemia risk. Our findings highlight the severity of the burden of anemia and micronutrient deficiencies in Eastern Maharashtra, but also highlight that in many cases, ID and anemia affect different individuals. Preventing and managing anemia in pregnancy in India will require strengthening both clinical and community-based strategies targeting iron deficiency, as well as other causes of anemia

Anemia · Environmental health · Ferritin · Hemoglobin · Iron deficiency · Micronutrient · Obstetrics · Pathology · Population · Pregnancy · Child Nutrition and Water Access · Hemoglobinopathies and Related Disorders · Iron Metabolism and Disorders · Medicine · Internal Medicine · Physiology