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Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Nutrition & Dietetics
  • hemoglobin
  • preconception
  • anemia
  • child development
  • birth outcomes
  • RANDOMIZED CONTROLLED-TRIAL
  • IRON-DEFICIENCY ANEMIA
  • MICRONUTRIENT SUPPLEMENTATION
  • GESTATIONAL-AGE
  • DEVELOPING-COUNTRIES
  • MOTOR DEVELOPMENT
  • RISK-FACTORS
  • FOLIC-ACID
  • PREGNANCY
  • BIRTH

Long-Term Association Between Maternal Preconception Hemoglobin Concentration, Anemia, and Child Health and Development in Vietnam

Tools:

Journal Title:

JOURNAL OF NUTRITION

Volume:

Volume 153, Number 5

Publisher:

, Pages 1597-1606

Type of Work:

Article

Abstract:

Background: The long-term association between preconception maternal hemoglobin (Hb) concentrations and child health and development is unclear. Objectives: We examined associations between maternal preconception Hb concentrations and anemia with 1) birth outcomes (weight, length, preterm, gestational age, small for gestational age); 2) child Hb at 3 mo, 6 mo, 12 mo, and 24 mo; and 3) motor and mental development at 12 mo and 24 mo (Bayley scales for infant development) and cognitive functioning at 6–7 y (Wechsler Intelligence Scale for Children). Methods: We used data from a randomized controlled trial (PRECONCEPT) conducted in Vietnam. Over 5000 women who were intending to conceive were recruited, and offspring were prospectively followed from birth (n = 1599) through 6–7 y (n = 1318). Multivariable linear and logistic regressions were used to assess the association between preconception Hb or anemia (Hb < 12g/dL) on child health and development outcomes, adjusted by supplementation group (tested for interactions) and confounding at maternal, child, and household levels. Results: At preconception enrollment, 20% of the women were anemic. Maternal preconception Hb was positively associated with child Hb at 3 mo (0.06; 95% CI: 0.01, 0.12), 6 mo (0.08; 95% CI: 0.03, 0.13), 12 mo (0.10; 95% CI: 0.04, 0.15), and 24 mo (0.07; 95% CI: 0.02, 0.12). Likewise, maternal preconception Hb was associated with reduced risk of child anemia at 6 mo (0.89; 95% CI: 0.81, 0.98), 12 mo (0.81; 95% CI: 0.74, 0.89), and 24 mo (0.87; 95% CI: 0.79, 0.95). Maternal preconception anemia was negatively associated with cognition (−1.64; 95% CI: −3.09, −0.19) and language development (−1.61; 95% CI: −3.20, −0.03) at 24 mo. Preconception Hb was not associated with birth outcomes or cognitive outcomes at 6–7 y. Conclusions: Maternal preconception Hb was associated with child Hb across the first 1000 d of life. However, preconception Hb was not a significant predictor of birth outcomes or cognitive outcomes at 6–7 y in this cohort from Vietnam. Clinical Trial Registration: PRECONCEPT study (NCT: 01665378).
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