Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 547

P12-001 - Anemia of Inflammation among iron-replete Tanzanian pregnant women is related to the risk of adverse perinatal outcomes

Sunday, Jun 10
8:00 AM – 6:00 PM

Objectives

Inflammation is a common cause of anemia in developing countries and potentially complicates the diagnosis, prevention and treatment of iron deficiency anemia. The aim of this analysis was to evaluate the association of anemia of inflammation and adverse pregnancy outcomes, and to assess effect measure modification of the effectiveness of iron supplementation in preventing iron deficiency and anemia.

Methods

Iron-replete (ferritin >12 µg/L) HIV-negative women (n=1500), in their 1st or 2nd pregnancies presenting to antenatal clinics in Dar es Salaam, Tanzania, from 2010 – 2013, were enrolled in a placebo-controlled iron supplementation (60mg daily) trial. Participants underwent regular clinical assessments and blood tests until delivery. Anemia of inflammation was defined as the finding of 1) sTfR-ferritin ratio < 1, or 2) ferritin >12 µg/L with inflammation (CRP >5 mg/l), in the presence of anemia (hemoglobin

Results

The mean age (±SD) of the women was 24 years (±4) and they were enrolled at a mean gestational age of 20weeks (±4). At baseline, the prevalence of anemia (hemoglobin

Anemia of inflammation at baseline was significantly related to the risk of placental malaria (RR=2.05; 95% confidence interval (CI):1.12 – 3.77), anemia at delivery (RR=1.51; 95% CI: 1.16 – 1.97), and birth defects (RR=3.55; 95% CI: 1.15 – 11.0). Anemic pregnant women with baseline sTfR-ferritin ratio >1 had a 5-folds greater risk of stillbirths (RR=5.08; 95% CI: 1.6 – 15.9). AI was not significantly associated with the risk of hospitalization for malaria, iron deficiency at delivery, small-for-gestational age, low birthweight or preterm birth. AI did not also significantly modify the effect of daily iron supplement use on the risk of clinical or hematologic outcomes.

 

Conclusion 

Anemia of inflammation during pregnancy, likely due to subclinical malaria, is associated with the risk of adverse maternal and perinatal outcomes. 


CoAuthors: Zulfiqarali Premji – School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Said Aboud – Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Anne Marie Darling – Harvard T.H. Chan School of Public Health, Boston MA, USA; Drucilla Roberts – Massachusetts General Hospital, Boston MA, USA; Christopher Duggan – Boston Children’s Hospital, Boston MA, USA; Wafaie Fawzi – Harvard T.H. Chan School of Public Health, Boston MA, USA

Ajibola I. Abioye

PhD Student
Harvard School of Public Health
Providence, Rhode Island