Determinants of haemoglobin level during pregnancy and relationship with pregnancy outcome in Bangladeshi urban poor

Abstract

Objective: Investigate the determinants of haemoglobin (Hb) level during pregnancy and relationship with the pregnancy outcome in Bangladeshi urban poor. Methodology: As part of a zinc supplementation trial, 559 women from Dhaka urban slums were enrolled between 12 and 16 weeks gestation. On enrollment, Hb and serum zinc levels were assessed. Anthropomet-ric measurements (weight, height, and MUAC) were taken, and information was collected on reproductive history, socioeconomic status, and dietary intake, including the use of iron supplements. Women were pro-spectively followed up until delivery, and repeated Hb assays were performed at 7 months gestation. Results: Mean Hb concentrations at enrollment and at 7 months gestation were 11.5±1.3 g/dl and 10.8±1.2 g/dl respectively (p<0.001) with 34.6% and 53.7% of the women classified as anaemic (Hb< 11 g/dl) at baseline and at 7 months gestation respectively. Lower nutritional status (body mass index, MUAC, and serum zinc) and lower socioeconomic status were associated with lower Hb levels at baseline. The use of iron supple¬ments was very low in this population: only 10 women (1.9%) reported to have taken iron tablets in the last 14 days, and no relationship between the use of iron tablets, and Hb levels was observed. The Hb levels at 4 months gestation were positively related to gestational length at birth as measured by LMP even after con¬trolling for other possibly confounding variables. Birth weight, length at birth, infant chest-head and MUAC at birth were not related to the Hb levels at 4 months gestation. The Hb levels at 7 months gestation were not related to pregnancy outcome. Conclusion: Anaemia in early pregnancy may be associated with a higher risk of prematurity based on LMP.