The aetiology of anaemia during pregnancy: a study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women

• Published in: Public health nutrition 2015-06, Vol.18 (8), p.1423-1435
• Main Authors: Baingana, Rhona K, Enyaru, John K, Tjalsma, Harold, Swinkels, Dorine W, Davidsson, Lena
• Format: Article
• Language: English
• Subjects: Adult; Anemia; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - complications; Anemia, Iron-Deficiency - epidemiology; Antigens; Biochemistry; Biomarkers; C-Reactive Protein - metabolism; Cross-Sectional Studies; Diagnostic tests; Etiology; Female; Ferritins - blood; Gestational age; Helicobacter pylori; Hemoglobins - metabolism; Hepcidins - blood; HIV; Households; Human immunodeficiency virus; Humans; Infections; Inflammation; Iron - blood; Iron Deficiencies; Laboratories; Logistic Models; Malaria; Malaria - blood; Malaria - complications; Malaria - epidemiology; Nutrient deficiency; Nutritional epidemiology; Orosomucoid - metabolism; Parasites; Pregnancy; Pregnancy Complications, Hematologic - blood; Pregnancy Complications, Hematologic - epidemiology; Prenatal care; Prevalence; Receptors, Transferrin - blood; Research Papers; Risk factors; Sexually transmitted diseases; Socioeconomic Factors; STD; Syphilis; Treponema pallidum; Uganda - epidemiology; Vector-borne diseases; Womens health; Young Adult
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1017/S1368980014001888

To describe the aetiology of anaemia in pregnant Ugandan women and explore Fe deficiency and common infections as contributors to anaemia in this population. Cross-sectional study in which Hb, ferritin, transferrin receptor (sTfR), C-reactive protein, α-1 acid glycoprotein, hepcidin, malaria, hookworm infestation, syphilis and Helicobacter pylori infection were assessed. Antenatal care clinic at Kawempe Health Centre, Kampala, Uganda. HIV-negative women (n 151) in their first or second pregnancy at 10-16 weeks' gestation. The prevalence of anaemia was 29·1 %. Fe deficiency was 40·4 % and 14·6 % based on ferritin 8·3 μg/ml. The prevalence of Fe-deficiency anaemia was 9·3 % based on ferritin 8·3 μg/ml. Hepcidin concentration was positively correlated with ferritin concentration (n 151, r=0·578, P1 g/l and/or C-reactive protein >5 mg/l. Malaria parasitaemia (OR=6·85; 95 % CI 1·25, 37·41, P=0·026) and Fe deficiency defined using sTfR (OR=5·58; 95 % CI 1·26, 24·80, P=0·024) were independently and positively associated with anaemia. Population-attributable risk factors for anaemia for raised C-reactive protein, Fe deficiency defined by sTfR >8·3 μg/ml and presence of malaria parasites were 41·6 (95 % CI 11·1, 72·2) %, 13·5 (95 % CI 2·0, 25·0) % and 12·0 (95 % CI 1·4, 22·6) %, respectively. Infections and inflammation are of greater significance than Fe deficiency in the aetiology of anaemia in pregnant Ugandan women during the first trimester.