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Chen GD, Li PS, Zhou ZX, Wang HY, Gou XY, Ye SX, Lin DX, Fan DZ, Wang LJ, Liu ZP. Associations of maternal serum concentration of iron-related indicators with birth outcomes in Chinese: a pilot prospective cohort study. Ital J Pediatr 2024; 50:39. [PMID: 38439018 PMCID: PMC10913255 DOI: 10.1186/s13052-024-01621-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/24/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Previous studies of maternal iron and birth outcomes have been limited to single indicators that do not reflect the comprehensive relationship with birth outcomes. We aimed to investigate the relationship between maternal iron metabolism and neonatal anthropometric indicators using comprehensive iron-related indicators. METHODS A total of 914 Chinese mother-child dyads were enrolled in this prospective study. Subjects' blood samples were collected at ≤ 14 weeks of gestation. Serum concentrations of iron-related indicators were measured by enzyme-linked immunosorbent assay (ELISA). Femur length was measured by B-ultrasound nearest delivery. Neonatal anthropometric indicators were collected from medical records. RESULTS After adjustment for potential covariates, higher iron (per one standard deviation, SD increase) was detrimentally associated with - 0.22 mm lower femur length, whereas higher transferrin (per one SD increase) was associated with 0.20 mm higher femur length. Compared with normal subjects (10th-90th percentiles), subjects with extremely high (> 90th percentile) iron concentration were detrimentally associated with lower femur length, birth weight, and chest circumference, and a higher risk of low birth weight, LBW (HR: 3.92, 95%CI: 1.28, 12.0). Subjects with high concentration of soluble transferrin receptor, sTFR and transferrin (> 90th percentile) were associated with higher femur length. Subjects with low concentration of iron and ferritin concentrations (< 10th percentile) were associated with a higher risk of LBW (HR: 4.10, 95%CI: 1.17, 14.3) and macrosomia (HR: 2.79, 95%CI: 1.06, 7.35), respectively. CONCLUSIONS Maternal iron overload in early pregnancy may be detrimentally associated with neonatal anthropometric indicators and adverse birth outcomes.
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Affiliation(s)
- Geng-Dong Chen
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China.
| | - Peng-Sheng Li
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China
| | - Zi-Xing Zhou
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China
| | - Hai-Yan Wang
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China
- Biobank of Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan, Guangdong, China
| | - Xiao-Yan Gou
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China
- Biobank of Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan, Guangdong, China
| | - Shao-Xin Ye
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China
| | - Dong-Xin Lin
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China
| | - Da-Zhi Fan
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China
| | - Li-Juan Wang
- Department of Obstetrics, Foshan Women and Children Hospital, No.11 Renmin West Road, Changchen District, 528000, Foshan City, Guangdong Province, China.
| | - Zheng-Ping Liu
- Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, 528000, Foshan city, Guangdong Province, China.
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Jha A, Chandrakar A. A Comparative Study of National Family Health Survey-4 and National Family Health Survey-5 of Nutritional Indicators in Chhattisgarh. Cureus 2024; 16:e55524. [PMID: 38576647 PMCID: PMC10991083 DOI: 10.7759/cureus.55524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
Globally, public health issues related to malnutrition exist. One of the countries grappling with challenges in combating anemia and malnutrition is India, including the state of Chhattisgarh. The National Family Health Survey-5 (NFHS-5) data show that the advancements made in the National Family Health Survey-4 (NFHS-4) were reversed in NFHS-5. Despite having several programs and policies in place, Chhattisgarh has not yet utilized all of its potential to demonstrate exponential reductions in anemia and malnutrition. This study highlights probable factors and inter-district variations to provide an overview of the nutritional condition of districts in Chhattisgarh compared to NFHS-4. Children under five who are severely wasted, stunted, or experiencing both conditions exhibit a lower prevalence. An immediate warning indication was the rise in anemia prevalence across all age categories. In Chhattisgarh, when comparing NFHS-5 to NFHS-4, the study identified a reduced frequency of direct determinants and an increased coverage of nutrition-specific treatments. The state of Chhattisgarh has seen a significant improvement in underlying factors, including the number of homes with power and drinking water quality. It also describes the shortcomings and advancements in the inter-district variations among the coverage factors. Instead of focusing on raising the nutritional indicators for Chhattisgarh, this study also includes initiatives made by states that have fared better in terms of those metrics.
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Affiliation(s)
- Anupriya Jha
- Community and Family Medicine, All India Institute of Medical Sciences, Raipur, IND
| | - Aditi Chandrakar
- Community and Family Medicine, All India Institute of Medical Sciences, Raipur, IND
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Babah OA, Akinajo OR, Beňová L, Hanson C, Abioye AI, Adaramoye VO, Adeyemo TA, Balogun MR, Banke-Thomas A, Galadanci HS, Sam-Agudu NA, Afolabi BB, Larsson EC. Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:39. [PMID: 38182997 PMCID: PMC10768359 DOI: 10.1186/s12884-023-06169-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 12/03/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria. METHODS In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA. RESULTS Iron deficiency was observed among 41% (95%CI: 38 - 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 - 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 - 0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 - 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 - 2.82). CONCLUSION About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries.
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Affiliation(s)
- Ochuwa Adiketu Babah
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Opeyemi Rebecca Akinajo
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ajibola Ibraheem Abioye
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Victoria Olawunmi Adaramoye
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Titilope A Adeyemo
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Mobolanle Rasheedat Balogun
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Aduragbemi Banke-Thomas
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Global Maternal and Newborn Health Hub, Institute of Lifecourse Development, University of Greenwich, London, UK
| | - Hadiza S Galadanci
- African Center of Excellence for Population Health and Policy, Bayero University, Kano, Nigeria
- Department of Obstetrics and Gynaecology, College of Health Sciences Bayero University Kano/ Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Bosede Bukola Afolabi
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Elin C Larsson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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