Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022:44:e2022100.
doi: 10.4178/epih.e2022100. Epub 2022 Nov 1.

Maternal pre-pregnancy anemia and childhood anemia in Indonesia: a risk assessment using a population-based prospective longitudinal study

Fadila Wirawan  1 , Dieta Nurrika  2
Affiliations

Maternal pre-pregnancy anemia and childhood anemia in Indonesia: a risk assessment using a population-based prospective longitudinal study

Fadila Wirawan et al. Epidemiol Health. 2022.

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.

Keywords: Anemia; Child; Iron deficiency; Maternal health; Preconception care; Pregnancy.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflicts of interest to declare for this study.

Figures

Figure 1
Figure 1
Study subject selection scheme. IFLS, Indonesian Family Life Survey; Hb, hemoglobin.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Wang L, Li M, Dill SE, Hu Y, Rozelle S. Dynamic anemia status from infancy to preschool-age: evidence from rural China. Int J Environ Res Public Health. 2019;16:2761. - PMC - PubMed
    1. Dos Santos RF, Gonzalez ES, de Albuquerque EC, de Arruda IK, Diniz Ada S, Figueroa JN, et al. Prevalence of anemia in under five-year-old children in a children’s hospital in Recife, Brazil. Rev Bras Hematol Hemoter. 2011;33:100–104. - PMC - PubMed
    1. Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1:e16–e25. - PMC - PubMed
    1. Geller SE, Koch AR, Garland CE, MacDonald EJ, Storey F, Lawton B. A global view of severe maternal morbidity: moving beyond maternal mortality. Reprod Health. 2018;15(Suppl 1):98. - PMC - PubMed
    1. United Nation Children’s Fund (UNICEF) Nutrition capacity assessment in Indonesia. 2018. [cited 2022 Aug 1]. Available from: https://www.unicef.org/indonesia/media/1816/file/Nutrition%20Assessment%... .