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

Research output: Contribution to journalJournal articleResearchpeer-review

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

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 languageEnglish
JournalTropical Medicine and International Health
Volume24
Issue number5
Pages (from-to)596-607
Number of pages12
ISSN1360-2276
DOIs
Publication statusPublished - 2019

    Research areas

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

ID: 216874282