Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years

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dc.creatorYoung, Melissa F.
dc.creatorNguyen, Phuong Hong
dc.creatorTran, Lan Mai
dc.creatorKhuong, Long Quynh
dc.creatorTandon, Sonia
dc.creatorMartorell, Reynaldo
dc.creatorRamakrishnan, Usha
dc.date2023-02-16
dc.date2024-03-14T12:09:28Z
dc.date2024-03-14T12:09:28Z
dc.date.accessioned2026-06-27T15:32:19Z
dc.descriptionBackground: The role of changes in maternal hemoglobin (Hb) across pregnancy on child health and development (CHD) remains unclear. Objective: We examined the association between maternal Hb trajectories and CHD outcomes: (a) birth outcomes (birth weight, length, gestational age, preterm, and small for gestational age); (b) child Hb at 3, 6, 12, and 24 months; and (c) motor and mental development at 12 and 24 months and cognitive functioning at age 6–7 years. Methods: We used data from a randomized controlled trial (PRECONCEPT) conducted in Vietnam (N = 1,175 women enrolled during preconception with offspring follow-up through 6–7 years). Maternal Hb trajectories were developed using latent class analysis with Hb data at preconception, early (≤20 weeks), mid (21–29 weeks), and late (≥30 weeks) pregnancy. Multivariable linear and logistic regression models were used to assess the association between maternal Hb trajectories on CHD outcomes, adjusting for confounding variables at the maternal, child and household levels. Results: Four distinct maternal Hb trajectories were identified. Track 1 (low initial Hb-decline) was associated with lower child Hb at 3 months (β [95% CI] −0.52 [−0.87, −0.16]), 6 months (−0.36 [−0.68, −0.05]), 12 months (−0.46 [−0.79, −0.13]), and 24 months (−0.44 [−0.72, −0.15]) and motor development at 12 months (−3.58 [−6.76, −0.40]) compared to track 4 (high initial Hb-decline). After adjustment for multiple testing, relationships remained robust with the exception of associations with child Hb at 6 months and motor development at 12 months. Track 2 (low initial Hb-improve) was the only Hb trajectory to increase across pregnancy; however, it was insufficiently powered. Track 3 (mid Hb-decline) was associated with lower child Hb at 12 months (−0.27 [−0.44, −0.10]) and 24 months (−0.20 [−0.34, −0.05]) compared to track 4 (high initial Hb-decline). Maternal Hb trajectories were not associated with birth outcomes or child development at 24 months or 6–7 years. Conclusion: Maternal Hb trajectories during pregnancy are associated with child Hb concentrations across the first 1,000 days, but not with birth outcomes or later cognitive functioning. More work is needed to better understand and interpret changes in Hb levels during pregnancy especially in resource poor settings.
dc.identifierhttps://hdl.handle.net/10568/140401
dc.identifier.urihttp://hdl.handle.net/123456789/107219
dc.languageen
dc.publisherFrontiers Media
dc.rightsOpen Access
dc.sourceYoung, Melissa F.; Nguyen, Phuong Hong; Tran, Lan Mai; Khuong, Long Quynh; Tandon, Sonia; Martorell, Reynaldo; and Ramakrishnan, Usha. 2023. Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years. Frontiers in Nutrition 10: 1114101. https://doi.org/10.3389/fnut.2023.1114101
dc.subjectanaemia
dc.subjectpregnancy
dc.subjectchild health
dc.subjecthaemoglobin
dc.subjectnutrition
dc.subjectchildren
dc.subjectchild growth
dc.titleMaternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years
dc.typeJournal Article

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Instituto Internacional de Investigación sobre Políticas Alimentarias (IFPRI)