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Fadila Wirawan 1 Article
Maternal pre-pregnancy anemia and childhood anemia in Indonesia: a risk assessment using a population-based prospective longitudinal study
Fadila Wirawan, Dieta Nurrika
Epidemiol Health. 2022;44:e2022100.   Published online November 1, 2022
DOI: https://doi.org/10.4178/epih.e2022100
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Anemia in children under 5 years of age is often overlooked despite its detrimental effects. The public health approach to anemia prevention includes the maternal pre-pregnancy phase. This study investigated the association between pre-pregnancy anemia and the risk of anemia in children under 5 years of age.
METHODS
This cohort study included non-pregnant women from the 2007 Indonesian Family Life Survey (IFLS) and their children under 5 in the 2014 IFLS. The anemia status of mothers and children was determined based on hemoglobin (Hb) levels using Hemocue. Mantel-Haenszel adjusted relative risks (aRRs), including risk stratification by covariates, were used for the final risk assessment.
RESULTS
In total, 637 children in the 2014 IFLS were included. The risk of having a child with anemia was 1.71-fold higher in women with pre-pregnancy anemia than in women without pre-pregnancy anemia (aRR, 1.71; 95% confidence interval [CI], 1.03 to 2.85). After risk stratification based on potential confounding variables, maternal pre-pregnancy anemia remained an independent risk factor for anemia in children who still breastfed at the time of data collection (relative risk [RR], 2.11; 95% CI, 1.16 to 3.86), in children who were given water earlier than 6 months of age (RR, 2.08; 95% CI, 1.20 to 3.61), in children of mothers with a normal or underweight pre-pregnancy body mass index (RR, 1.94; 95% CI, 1.20 to 3.14), and in children of mothers without current anemia (RR, 2.20; 95% CI, 1.21 to 3.99).
CONCLUSIONS
Pre-pregnancy anemia increased the risk of childhood anemia. A public health approach emphasizing pre-conception maternal health would enable better maternal and child morbidity risk prevention.
Summary
Key Message
Pre-pregnancy anemia increased the risk of childhood anemia by 1.7 times compared to without pre-pregnancy anemia, and increased when the child was still breastfed, given water before 6 months of age, and the mother had a normal or underweight pre-pregnancy BMI, regardless of the mother’s current no anemia status.

Citations

Citations to this article as recorded by  
  • Identification and treatment of iron‐deficiency anemia in pregnancy and postpartum: A systematic review and quality appraisal of guidelines using AGREE II
    Victoria Mintsopoulos, Evan Tannenbaum, A. Kinga Malinowski, Nadine Shehata, Melissa Walker
    International Journal of Gynecology & Obstetrics.2024; 164(2): 460.     CrossRef
  • Prevalence and risk factors of anemia in the mother–child population from a region of the Colombian Caribbean
    Lisetta Del Castillo, Nora Cardona-Castro, Denis R. Whelan, John Paul Builes, Héctor Serrano-Coll, Margarita Arboleda, Juan S. Leon
    BMC Public Health.2023;[Epub]     CrossRef
  • Iron deficiency anemia in pregnant women
    L. D. Belotserkovtseva, L. V. Kovalenko, V. N. Zinin, S. E. Ivannikov, M. R. Keldasova
    Ural Medical Journal.2023; 22(5): 140.     CrossRef
  • Safety monitoring of oral iron supplements in pregnant women with anemia: a multi-center observational clinical study
    Chang Liu, Qianqian Zhang, Peiye Hui, Yan Wang, Guohui Li, Guangchao Cao, Zicheng Xue, Jing Zhang, Heng Zhang, Xin Huang, Jiyong Wu, Fusehng Sun, Meixing Yan
    Therapeutic Advances in Drug Safety.2023;[Epub]     CrossRef

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