Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study

Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Carboo, Janet Adede [verfasserIn] Ngounda, Jennifer [verfasserIn] Baumgartner, Jeannine [verfasserIn] Robb, Liska [verfasserIn] Jordaan, Marizeth [verfasserIn] Walsh, Corinna May [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2024

Schlagwörter:	Pregnancy Birth outcomes Anaemia Iron deficiency Iron deficiency anaemia Iron deficiency erythropoiesis Iron supplementation

Anmerkung:	© The Author(s) 2024

Übergeordnetes Werk:	Enthalten in: BMC pregnancy and childbirth - BioMed Central, 2001, 24(2024), 1 vom: 04. Okt.
Übergeordnetes Werk:	volume:24 ; year:2024 ; number:1 ; day:04 ; month:10

Links:	Volltext

DOI / URN:	10.1186/s12884-024-06845-w

Katalog-ID:	SPR057672342

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100	1		\|a Carboo, Janet Adede \|e verfasserin \|4 aut
245	1	0	\|a Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study
264		1	\|c 2024
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520			\|a Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract
520			\|a Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV.
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650		4	\|a Birth outcomes \|7 (dpeaa)DE-He213
650		4	\|a Anaemia \|7 (dpeaa)DE-He213
650		4	\|a Iron deficiency \|7 (dpeaa)DE-He213
650		4	\|a Iron deficiency anaemia \|7 (dpeaa)DE-He213
650		4	\|a Iron deficiency erythropoiesis \|7 (dpeaa)DE-He213
650		4	\|a Iron supplementation \|7 (dpeaa)DE-He213
700	1		\|a Ngounda, Jennifer \|e verfasserin \|4 aut
700	1		\|a Baumgartner, Jeannine \|e verfasserin \|4 aut
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700	1		\|a Jordaan, Marizeth \|e verfasserin \|4 aut
700	1		\|a Walsh, Corinna May \|e verfasserin \|4 aut
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spelling	10.1186/s12884-024-06845-w doi (DE-627)SPR057672342 (SPR)s12884-024-06845-w-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Carboo, Janet Adede verfasserin aut Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV. Pregnancy (dpeaa)DE-He213 Birth outcomes (dpeaa)DE-He213 Anaemia (dpeaa)DE-He213 Iron deficiency (dpeaa)DE-He213 Iron deficiency anaemia (dpeaa)DE-He213 Iron deficiency erythropoiesis (dpeaa)DE-He213 Iron supplementation (dpeaa)DE-He213 Ngounda, Jennifer verfasserin aut Baumgartner, Jeannine verfasserin aut Robb, Liska verfasserin aut Jordaan, Marizeth verfasserin aut Walsh, Corinna May verfasserin aut Enthalten in BMC pregnancy and childbirth BioMed Central, 2001 24(2024), 1 vom: 04. Okt. (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:24 year:2024 number:1 day:04 month:10 https://dx.doi.org/10.1186/s12884-024-06845-w X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 04 10
allfields_unstemmed	10.1186/s12884-024-06845-w doi (DE-627)SPR057672342 (SPR)s12884-024-06845-w-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Carboo, Janet Adede verfasserin aut Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV. Pregnancy (dpeaa)DE-He213 Birth outcomes (dpeaa)DE-He213 Anaemia (dpeaa)DE-He213 Iron deficiency (dpeaa)DE-He213 Iron deficiency anaemia (dpeaa)DE-He213 Iron deficiency erythropoiesis (dpeaa)DE-He213 Iron supplementation (dpeaa)DE-He213 Ngounda, Jennifer verfasserin aut Baumgartner, Jeannine verfasserin aut Robb, Liska verfasserin aut Jordaan, Marizeth verfasserin aut Walsh, Corinna May verfasserin aut Enthalten in BMC pregnancy and childbirth BioMed Central, 2001 24(2024), 1 vom: 04. Okt. (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:24 year:2024 number:1 day:04 month:10 https://dx.doi.org/10.1186/s12884-024-06845-w X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 04 10
allfieldsGer	10.1186/s12884-024-06845-w doi (DE-627)SPR057672342 (SPR)s12884-024-06845-w-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Carboo, Janet Adede verfasserin aut Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV. Pregnancy (dpeaa)DE-He213 Birth outcomes (dpeaa)DE-He213 Anaemia (dpeaa)DE-He213 Iron deficiency (dpeaa)DE-He213 Iron deficiency anaemia (dpeaa)DE-He213 Iron deficiency erythropoiesis (dpeaa)DE-He213 Iron supplementation (dpeaa)DE-He213 Ngounda, Jennifer verfasserin aut Baumgartner, Jeannine verfasserin aut Robb, Liska verfasserin aut Jordaan, Marizeth verfasserin aut Walsh, Corinna May verfasserin aut Enthalten in BMC pregnancy and childbirth BioMed Central, 2001 24(2024), 1 vom: 04. Okt. (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:24 year:2024 number:1 day:04 month:10 https://dx.doi.org/10.1186/s12884-024-06845-w X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 04 10
allfieldsSound	10.1186/s12884-024-06845-w doi (DE-627)SPR057672342 (SPR)s12884-024-06845-w-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Carboo, Janet Adede verfasserin aut Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV. Pregnancy (dpeaa)DE-He213 Birth outcomes (dpeaa)DE-He213 Anaemia (dpeaa)DE-He213 Iron deficiency (dpeaa)DE-He213 Iron deficiency anaemia (dpeaa)DE-He213 Iron deficiency erythropoiesis (dpeaa)DE-He213 Iron supplementation (dpeaa)DE-He213 Ngounda, Jennifer verfasserin aut Baumgartner, Jeannine verfasserin aut Robb, Liska verfasserin aut Jordaan, Marizeth verfasserin aut Walsh, Corinna May verfasserin aut Enthalten in BMC pregnancy and childbirth BioMed Central, 2001 24(2024), 1 vom: 04. Okt. (DE-627)335489087 (DE-600)2059869-5 1471-2393 nnns volume:24 year:2024 number:1 day:04 month:10 https://dx.doi.org/10.1186/s12884-024-06845-w X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 04 10
language	English
source	Enthalten in BMC pregnancy and childbirth 24(2024), 1 vom: 04. Okt. volume:24 year:2024 number:1 day:04 month:10
sourceStr	Enthalten in BMC pregnancy and childbirth 24(2024), 1 vom: 04. Okt. volume:24 year:2024 number:1 day:04 month:10
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Pregnancy Birth outcomes Anaemia Iron deficiency Iron deficiency anaemia Iron deficiency erythropoiesis Iron supplementation
dewey-raw	610
isfreeaccess_bool	true
container_title	BMC pregnancy and childbirth
authorswithroles_txt_mv	Carboo, Janet Adede @@aut@@ Ngounda, Jennifer @@aut@@ Baumgartner, Jeannine @@aut@@ Robb, Liska @@aut@@ Jordaan, Marizeth @@aut@@ Walsh, Corinna May @@aut@@
publishDateDaySort_date	2024-10-04T00:00:00Z
hierarchy_top_id	335489087
dewey-sort	3610
id	SPR057672342
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">SPR057672342</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20241005064736.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">241005s2024 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s12884-024-06845-w</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR057672342</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12884-024-06845-w-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.00</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Carboo, Janet Adede</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2024</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s) 2024</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. 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author	Carboo, Janet Adede
spellingShingle	Carboo, Janet Adede ddc 610 bkl 44.00 misc Pregnancy misc Birth outcomes misc Anaemia misc Iron deficiency misc Iron deficiency anaemia misc Iron deficiency erythropoiesis misc Iron supplementation Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study
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topic_title	610 VZ 44.00 bkl Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study Pregnancy (dpeaa)DE-He213 Birth outcomes (dpeaa)DE-He213 Anaemia (dpeaa)DE-He213 Iron deficiency (dpeaa)DE-He213 Iron deficiency anaemia (dpeaa)DE-He213 Iron deficiency erythropoiesis (dpeaa)DE-He213 Iron supplementation (dpeaa)DE-He213
topic	ddc 610 bkl 44.00 misc Pregnancy misc Birth outcomes misc Anaemia misc Iron deficiency misc Iron deficiency anaemia misc Iron deficiency erythropoiesis misc Iron supplementation
topic_unstemmed	ddc 610 bkl 44.00 misc Pregnancy misc Birth outcomes misc Anaemia misc Iron deficiency misc Iron deficiency anaemia misc Iron deficiency erythropoiesis misc Iron supplementation
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title	Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study
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title_full	Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study
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title_sort	iron status, anemia, and birth outcomes among pregnant women in urban bloemfontein, south africa: the nuemi study
title_auth	Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study
abstract	Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV. © The Author(s) 2024
abstractGer	Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV. © The Author(s) 2024
abstract_unstemmed	Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV. © The Author(s) 2024
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title_short	Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study
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up_date	2024-10-05T07:44:13.427Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">SPR057672342</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20241005064736.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">241005s2024 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s12884-024-06845-w</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR057672342</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12884-024-06845-w-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.00</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Carboo, Janet Adede</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2024</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s) 2024</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Despite routine iron supplementation for pregnant women in South Africa, anaemia and iron deficiency (ID) in pregnancy remain a public health concern. Objective To determine the associations between iron status and birth outcomes of pregnant women attending antenatal clinic at a regional hospital in Bloemfontein. Methods In this cross-sectional study of 427 pregnant women, blood was taken to analyze biomarkers of anaemia (haemoglobin), iron status (ferritin and soluble transferrin receptor) and inflammation (C-reactive protein and α-1-acid glycoprotein). A questionnaire was used to collect information about birth outcomes (birth weight and gestational age at birth), HIV exposure, sociodemographics, iron supplement intake, and maternal dietary iron intake using a validated quantified food frequency questionnaire. Results The median ($ Q_{1} $, $ Q_{3} $) weeks of gestation of participants was 32 (26, 36) at enrolment. Anaemia, iron deficiency (ID), ID anaemia (IDA) and ID erythropoiesis (IDE) were present in 42%, 31%, 19% and 9.8% of participants, respectively. Median ($ Q_{1} $, $ Q_{3} $) dietary and supplemental iron intake during pregnancy was 16.8 (12.7, 20.5) mg/d and 65 (65, 65) mg/d, respectively. The median (max-min) total iron intake (diet and supplements) was 81 (8.8-101.8) mg/d, with 88% of participants having a daily intake above the tolerable upper intake level of 45 mg/d. No significant associations of anaemia and iron status with low birth weight and prematurity were observed. However, infants born to participants in the third hemoglobin (Hb) quartile (Hb > 11.3–12.2 g/dL) had a shorter gestation by 1 week than those in the fourth Hb quartile (Hb > 12.2 g/dL) (p = 0.009). Compared to pregnant women without HIV, women with HIV had increased odds of being anaemic (OR:2.14, 95%CI: 1.41, 3.247), having ID (OR:2.19, 95%CI: 1.42, 3.37), IDA (OR:2.23, 95%CI: 1.36, 3.67), IDE (OR:2.22, 95%CI: 1.16, 4.22) and delivering prematurely (OR:2.39, 95%CI: 1.01, 5.64). Conclusion In conclusion, anaemia, ID, and IDA were prevalent in this sample of pregnant women, despite the reported intake of prescribed iron supplements, with HIV-infected participants more likely to be iron deficient and anaemic. Research focusing on the best formulation and dosage of iron supplementation to enhance iron absorption and status, and compliance to supplementation is recommended, especially for those living with HIV infection. Graphical Abstract</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Highlights • Only 19% of the pregnant women met the daily estimated average requirement for iron through dietary intake, highlighting the need for iron supplementation.• Despite the intake of routine 65 mg of elemental iron as a single micronutrient, anaemia and iron deficiency was prevalent in 42% and 31% of pregnant women respectively.•In the total sample, anaemia, iron deficiency, iron deficiency anaemia (IDA), and iron deficiency erythropoiesis (IDE) were not associated with low birth weight and premature birth.• Women living with HIV had over two times increased odds of being anaemic, iron deficient, having IDA and IDE, and delivering prematurely compared to those without HIV.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Pregnancy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Birth outcomes</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Anaemia</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Iron deficiency</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Iron deficiency anaemia</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Iron deficiency erythropoiesis</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Iron supplementation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ngounda, Jennifer</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Baumgartner, Jeannine</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Robb, Liska</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Jordaan, Marizeth</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Walsh, Corinna May</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">BMC pregnancy and childbirth</subfield><subfield code="d">BioMed Central, 2001</subfield><subfield code="g">24(2024), 1 vom: 04. 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Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study

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