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Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community‐based cohort study in rural northeastern Tanzania
Author(s) -
Schmiegelow Christentze,
Msemo Omari Abdul,
Møller Sofie Lykke,
Nielsen Birgitte Bruun,
Paulsen Cecilie Bøge,
Ødum Lars,
Theander Thor Grundtvig,
Kavishe Reginald Adolph,
Lusingu John Peter Andrea,
Minja Daniel Thomas,
Bygbjerg Ib Christian
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13219
Subject(s) - medicine , pregnancy , obstetrics , gestation , micronutrient , gynecology , genetics , pathology , biology
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.