Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Budi Kemuliaan Hospital, Jakarta, Indonesia.
BMC Public Health. 2018 Jul 13;18(1):873. doi: 10.1186/s12889-018-5704-2.
Anaemia is common among pregnant women, especially in low- and middle-income countries (LMICs). While body mass index (BMI) relates to many risk factors for anaemia in pregnancy, little is known about the direct relation with anaemia itself. This is particularly relevant in Southeast Asia and Sub-Saharan Africa where the prevalence of anaemia in pregnancy and the associated adverse outcomes is among the highest worldwide. This study aimed to assess the association between early pregnancy BMI and anaemia at first antenatal care visit in Indonesian and Ghanaian women. In addition, the associations between early pregnancy anaemia and adverse birth outcomes was assessed.
Prospective cohort studies of women in early pregnancy were conducted in Jakarta, Indonesia (n = 433) and in Accra, Ghana (n = 946), between 2012 and 2014. Linear regression analysis was used to assess relations between early pregnancy BMI and pregnancy haemoglobin levels at booking. Logistic regression analyses were used to assess associations between early pregnancy anaemia as defined by the World Health Organization (WHO) criteria and a composite of adverse birth outcomes including stillbirth, low birth weight and preterm birth.
Indonesian women had lower BMI than Ghanaian women (23.0 vs 25.4 kg/m, p < 0.001) and higher mean haemoglobin levels (12.4 vs 11.1 g/dL, p < 0.001), corresponding to anaemia prevalence of 10 and 44%, respectively. Higher early pregnancy BMI was associated with higher haemoglobin levels in Indonesian (0.054 g/dL/kg/m, 95% CI 0.03 to 0.08, p < 0.001) and Ghanaian women (0.044 g/dL/kg/m, 0.02 to 0.07, p < 0.001). Accordingly, risk for anaemia decreased with higher early pregnancy BMI for Indonesians (adjusted OR 0.88, 0.81 to 0.97, p = 0.01) and Ghanaians (adjusted OR 0.95, 0.92 to 0.98, p < 0.001). No association between anaemia and the composite of adverse birth outcomes was observed.
Higher BMI in early pregnancy is associated with higher haemoglobin levels at antenatal booking and with a reduced risk of anaemia in Indonesian and Ghanaian women.
贫血在孕妇中很常见，尤其是在中低收入国家（LMICs）。虽然体重指数（BMI）与妊娠贫血的许多危险因素有关，但对于其与贫血本身的直接关系知之甚少。在东南亚和撒哈拉以南非洲，妊娠贫血的患病率以及相关不良结局是全世界最高的，这一点尤其重要。本研究旨在评估印度尼西亚和加纳妇女早孕 BMI 与首次产前检查时贫血的关系。此外，还评估了早孕贫血与不良分娩结局之间的关系。
2012 年至 2014 年，在印度尼西亚雅加达（n=433）和加纳阿克拉（n=946）进行了孕妇早孕的前瞻性队列研究。线性回归分析用于评估早孕 BMI 与产前检查时妊娠血红蛋白水平之间的关系。逻辑回归分析用于评估世界卫生组织（WHO）标准定义的早孕贫血与包括死胎、低出生体重和早产在内的不良分娩结局综合指标之间的关系。
印度尼西亚妇女的 BMI 低于加纳妇女（23.0 与 25.4 kg/m2，p<0.001），平均血红蛋白水平较高（12.4 与 11.1 g/dL，p<0.001），相应的贫血患病率分别为 10%和 44%。在印度尼西亚妇女（0.054 g/dL/kg/m，95%CI 0.03 至 0.08，p<0.001）和加纳妇女（0.044 g/dL/kg/m，0.02 至 0.07，p<0.001）中，较高的早孕 BMI 与较高的血红蛋白水平相关。因此，对于印度尼西亚人（调整后的 OR 0.88，0.81 至 0.97，p=0.01）和加纳人（调整后的 OR 0.95，0.92 至 0.98，p<0.001），较高的早孕 BMI 与贫血风险降低相关。未观察到贫血与不良分娩结局综合指标之间存在关联。
早孕 BMI 较高与产前检查时血红蛋白水平较高以及印度尼西亚和加纳妇女贫血风险降低相关。
