Preconceptional factors associated with hemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania.

OBJECTIVE: Maternal anemia in early pregnancy is associated with poor pregnancy outcomes. Furthermore, preconceptional health can influence the health during pregnancy. The aim of this study was to investigate which preconceptional factors were associated with Hb concentration in early pregnancy.

METHODS: In Tanzania, 226 women were followed preconception and during early pregnancy. Red blood cell (RBC) morphology, serum micronutrient concentration, demographic characteristics, and health status were assessed preconception and in early pregnancy. The association between preconceptional factors and hemoglobin (Hb) concentration in early pregnancy was investigated using simple and multiple linear regression analyses stratified by preconceptional anemia status.

RESULTS: Mean Hb was 123g/L and 119g/L before conception and during early pregnancy (median gestational age 53 days), respectively. Preconceptional mid-upper arm circumference (MUAC) (adjusted coefficient (AC) 0.35 95% CI 0.9-0.61) and preconceptional Hb concentration (AC 0.45 95% CI 0.36-0.54) were positively associated with early pregnancy Hb concentration, whereas preconceptional microcytic hypochromic RBC morphology (AC -6.00 95% CI -9.56 to -2.44) was negatively associated with early pregnancy Hb concentration. In addition, treatment of preconceptional malaria was positively associated with early pregnancy Hb concentration (AC 6.45 95% CI 0.74-12.2) among women with preconceptional anemia. In contrast, among preconceptional non-anemic women, only preconceptional Hb concentration and medium socio-economic status was positively associated with early pregnancy Hb concentration.

CONCLUSIONS: MUAC and Hb measurements preconception can help to detect women at increased risk of low Hb concentration in early pregnancy. This article is protected by copyright. All rights reserved.