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Original Articles
Maternal pre-pregnancy anemia and childhood anemia in Indonesia: a risk assessment using a population-based prospective longitudinal study
Fadila Wirawan, Dieta Nurrika
Epidemiol Health. 2022;44:e2022100.   Published online November 1, 2022
DOI: https://doi.org/10.4178/epih.e2022100
  • 5,322 View
  • 233 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.
Summary
Key Message
Pre-pregnancy anemia increased the risk of childhood anemia by 1.7 times compared to without pre-pregnancy anemia, and increased when the child was still breastfed, given water before 6 months of age, and the mother had a normal or underweight pre-pregnancy BMI, regardless of the mother’s current no anemia status.

Citations

Citations to this article as recorded by  
  • Identification and treatment of iron‐deficiency anemia in pregnancy and postpartum: A systematic review and quality appraisal of guidelines using AGREE II
    Victoria Mintsopoulos, Evan Tannenbaum, A. Kinga Malinowski, Nadine Shehata, Melissa Walker
    International Journal of Gynecology & Obstetrics.2024; 164(2): 460.     CrossRef
  • Prevalence and risk factors of anemia in the mother–child population from a region of the Colombian Caribbean
    Lisetta Del Castillo, Nora Cardona-Castro, Denis R. Whelan, John Paul Builes, Héctor Serrano-Coll, Margarita Arboleda, Juan S. Leon
    BMC Public Health.2023;[Epub]     CrossRef
  • Iron deficiency anemia in pregnant women
    L. D. Belotserkovtseva, L. V. Kovalenko, V. N. Zinin, S. E. Ivannikov, M. R. Keldasova
    Ural Medical Journal.2023; 22(5): 140.     CrossRef
  • Safety monitoring of oral iron supplements in pregnant women with anemia: a multi-center observational clinical study
    Chang Liu, Qianqian Zhang, Peiye Hui, Yan Wang, Guohui Li, Guangchao Cao, Zicheng Xue, Jing Zhang, Heng Zhang, Xin Huang, Jiyong Wu, Fusehng Sun, Meixing Yan
    Therapeutic Advances in Drug Safety.2023;[Epub]     CrossRef
Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran’s position?
Elham Khatooni, Isa Akbarzadeh, Elham Abdalmaleki, Zhaleh Abdi, Elham Ahmadnezhad
Epidemiol Health. 2019;41:e2019045.   Published online October 11, 2019
DOI: https://doi.org/10.4178/epih.e2019045
  • 10,500 View
  • 168 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.
METHODS
This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.
RESULTS
Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.
CONCLUSIONS
Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.
Summary

Citations

Citations to this article as recorded by  
  • Iranian women's birth experiences: a cross-sectional study
    Mona Ghobadi, Farzaneh Pazandeh, Barbara Potrata, Ehsan Kazemnejad Lili
    British Journal of Midwifery.2022; 30(12): 685.     CrossRef
  • Sanctions on Iran and their impact on child health*
    Yasmin Madani-Lavassani
    Medicine, Conflict and Survival.2020; 36(4): 359.     CrossRef
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