Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia.
Department of Public Health, Banten School of Health Science, South Tangerang, Indonesia.
Epidemiol Health. 2022;44:e2022100. doi: 10.4178/epih.e2022100. Epub 2022 Nov 1.
Anemia in children under 5 years of age is often overlooked despite its detrimental effects. The public health approach to anemia prevention includes the maternal pre-pregnancy phase. This study investigated the association between pre-pregnancy anemia and the risk of anemia in children under 5 years of age.
This cohort study included non-pregnant women from the 2007 Indonesian Family Life Survey (IFLS) and their children under 5 in the 2014 IFLS. The anemia status of mothers and children was determined based on hemoglobin (Hb) levels using Hemocue. Mantel-Haenszel adjusted relative risks (aRRs), including risk stratification by covariates, were used for the final risk assessment.
In total, 637 children in the 2014 IFLS were included. The risk of having a child with anemia was 1.71-fold higher in women with pre-pregnancy anemia than in women without pre-pregnancy anemia (aRR, 1.71; 95% confidence interval [CI], 1.03 to 2.85). After risk stratification based on potential confounding variables, maternal pre-pregnancy anemia remained an independent risk factor for anemia in children who still breastfed at the time of data collection (relative risk [RR], 2.11; 95% CI, 1.16 to 3.86), in children who were given water earlier than 6 months of age (RR, 2.08; 95% CI, 1.20 to 3.61), in children of mothers with a normal or underweight pre-pregnancy body mass index (RR, 1.94; 95% CI, 1.20 to 3.14), and in children of mothers without current anemia (RR, 2.20; 95% CI, 1.21 to 3.99).
Pre-pregnancy anemia increased the risk of childhood anemia. A public health approach emphasizing pre-conception maternal health would enable better maternal and child morbidity risk prevention.
尽管儿童贫血会产生有害影响，但 5 岁以下儿童贫血仍常被忽视。预防贫血的公共卫生方法包括孕妇在怀孕前阶段。本研究旨在调查孕妇贫血与 5 岁以下儿童贫血风险之间的关联。
本队列研究纳入了来自 2007 年印度尼西亚家庭生活调查（IFLS）的非孕妇及其在 2014 年 IFLS 中 5 岁以下的子女。采用 Hemocue 基于血红蛋白（Hb）水平确定母亲和儿童的贫血状况。采用 Mantel-Haenszel 调整相对风险（aRR），包括根据协变量进行风险分层，用于最终风险评估。
本研究共纳入 2014 年 IFLS 中的 637 名儿童。与无孕前贫血的妇女相比，孕前贫血的妇女其子女患贫血的风险高 1.71 倍（aRR，1.71；95%置信区间 [CI]，1.03 至 2.85）。在基于潜在混杂变量进行风险分层后，在数据收集时仍在母乳喂养的儿童（相对风险 [RR]，2.11；95%CI，1.16 至 3.86）、6 个月前开始饮水的儿童（RR，2.08；95%CI，1.20 至 3.61）、母亲孕前体重指数正常或偏低的儿童（RR，1.94；95%CI，1.20 至 3.14）以及母亲当前无贫血的儿童（RR，2.20；95%CI，1.21 至 3.99）中，孕前贫血仍然是儿童贫血的独立危险因素。
孕前贫血增加了儿童贫血的风险。强调孕前产妇健康的公共卫生方法将能够更好地预防母婴发病率风险。
