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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978095/ https://www.ncbi.nlm.nih.gov/pubmed/36875831 http://dx.doi.org/10.3389/fnut.2023.1114101 |
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author | Young, Melissa F. Nguyen, Phuong Tran, Lan Mai Khuong, Long Quynh Tandon, Sonia Martorell, Reynaldo Ramakrishnan, Usha |
author_facet | Young, Melissa F. Nguyen, Phuong Tran, Lan Mai Khuong, Long Quynh Tandon, Sonia Martorell, Reynaldo Ramakrishnan, Usha |
author_sort | Young, Melissa F. |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-9978095 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-99780952023-03-03 Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6–7 years Young, Melissa F. Nguyen, Phuong Tran, Lan Mai Khuong, Long Quynh Tandon, Sonia Martorell, Reynaldo Ramakrishnan, Usha Front Nutr Nutrition 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. Frontiers Media S.A. 2023-02-16 /pmc/articles/PMC9978095/ /pubmed/36875831 http://dx.doi.org/10.3389/fnut.2023.1114101 Text en Copyright © 2023 Young, Nguyen, Tran, Khuong, Tandon, Martorell and Ramakrishnan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Nutrition Young, Melissa F. Nguyen, Phuong 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 | Nutrition |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978095/ https://www.ncbi.nlm.nih.gov/pubmed/36875831 http://dx.doi.org/10.3389/fnut.2023.1114101 |
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