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

Background: 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...

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Autores principales: Young, Melissa F., Nguyen, Phuong Hong, Tran, Lan Mai, Khuong, Long Quynh, Tandon, Sonia, Martorell, Reynaldo, Ramakrishnan, Usha
Formato: Journal Article
Lenguaje:Inglés
Publicado: Frontiers Media 2023
Materias:
Acceso en línea:https://hdl.handle.net/10568/140401
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author Young, Melissa F.
Nguyen, Phuong Hong
Tran, Lan Mai
Khuong, Long Quynh
Tandon, Sonia
Martorell, Reynaldo
Ramakrishnan, Usha
author_browse Khuong, Long Quynh
Martorell, Reynaldo
Nguyen, Phuong Hong
Ramakrishnan, Usha
Tandon, Sonia
Tran, Lan Mai
Young, Melissa F.
author_facet Young, Melissa F.
Nguyen, Phuong Hong
Tran, Lan Mai
Khuong, Long Quynh
Tandon, Sonia
Martorell, Reynaldo
Ramakrishnan, Usha
author_sort Young, Melissa F.
collection Repository of Agricultural Research Outputs (CGSpace)
description Background: 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.
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spelling CGSpace1404012025-12-08T10:29:22Z Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years Young, Melissa F. Nguyen, Phuong Hong Tran, Lan Mai Khuong, Long Quynh Tandon, Sonia Martorell, Reynaldo Ramakrishnan, Usha anaemia pregnancy child health haemoglobin nutrition children child growth Background: 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. 2023-02-16 2024-03-14T12:09:28Z 2024-03-14T12:09:28Z Journal Article https://hdl.handle.net/10568/140401 en Open Access Frontiers Media Young, 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
spellingShingle anaemia
pregnancy
child health
haemoglobin
nutrition
children
child growth
Young, Melissa F.
Nguyen, Phuong Hong
Tran, Lan Mai
Khuong, Long Quynh
Tandon, Sonia
Martorell, Reynaldo
Ramakrishnan, Usha
Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years
title Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years
title_full Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years
title_fullStr Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years
title_full_unstemmed Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years
title_short Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6-7 years
title_sort maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6 7 years
topic anaemia
pregnancy
child health
haemoglobin
nutrition
children
child growth
url https://hdl.handle.net/10568/140401
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