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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / complications
  • Anemia, Iron-Deficiency / epidemiology*
  • C-Reactive Protein / metabolism
  • Cross-Sectional Studies
  • Female
  • Ferritins / blood
  • Hemoglobins / metabolism
  • Hepcidins / blood
  • Humans
  • Iron / blood
  • Iron / deficiency*
  • Logistic Models
  • Malaria / blood
  • Malaria / complications
  • Malaria / epidemiology*
  • Orosomucoid / metabolism
  • Pregnancy
  • Pregnancy Complications, Hematologic / blood
  • Pregnancy Complications, Hematologic / epidemiology*
  • Prevalence
  • Receptors, Transferrin / blood
  • Socioeconomic Factors
  • Uganda / epidemiology
  • Young Adult

Substances

  • Hemoglobins
  • Hepcidins
  • Orosomucoid
  • Receptors, Transferrin
  • C-Reactive Protein
  • Ferritins
  • Iron