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Public Health Nutr. 2015 Jun;18(8):1423-35. doi: 10.1017/S1368980014001888. Epub 2014 Sep 15.

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

Author information

1
1Department of Biochemistry and Sports Science,College of Natural Sciences,Makerere University,PO Box 7062,Kampala,Uganda.
2
2Department of Laboratory Medicine,Radboud University Medical Center,Nijmegen,The Netherlands.
3
3Kuwait Institute for Scientific Research,Food and Nutrition Program,Environment and Life Sciences Research Center,Kuwait.

Abstract

OBJECTIVE:

To describe the aetiology of anaemia in pregnant Ugandan women and explore Fe deficiency and common infections as contributors to anaemia in this population.

DESIGN:

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.

SETTING:

Antenatal care clinic at Kawempe Health Centre, Kampala, Uganda.

SUBJECTS:

HIV-negative women (n 151) in their first or second pregnancy at 10-16 weeks' gestation.

RESULTS:

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.

CONCLUSIONS:

Infections and inflammation are of greater significance than Fe deficiency in the aetiology of anaemia in pregnant Ugandan women during the first trimester.

KEYWORDS:

Uganda

PMID:
25222882
DOI:
10.1017/S1368980014001888
[Indexed for MEDLINE]

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