Genetic Hemoglobin Disorders Rather Than Iron Deficiency Are a Major Predictor of Hemoglobin Concentration in Women of Reproductive Age in Rural Prey Veng, Cambodia,

Karakochuk, Crystal D; Whitfield, Kyly C.; Barr, Susan I.; Lamers, Yvonne; Devlin, Angela M.; Vercauteren, Suzanne; Kroeun, Hou; Talukder, Aminuzzaman; McLean, J.; Green, Timothy

doi:10.3945/jn.114.198945

Cited by 63 publications

(96 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further, as more than 80% of women reported taking an IFA supplement at the time of the survey, the lack of association between IFA supplementation and Hb concentration was unexpected. Though we did not measure biochemical markers of iron status (e.g., serum ferritin, transferrin saturation, and soluble transferrin receptor), the weak associations between IFA and Hb concentration and IFA and anemia in our study support the growing evidence 11,12 that iron deficiency may not be the primary cause of anemia in Cambodian women.…”

Section: Discussionsupporting

confidence: 68%

“…In a study involving 420 non-pregnant women in Prey Veng Province, Karakochuk and others 11 found that more than half of the women had a genetic hemoglobinopathy (predominantly Hb E variants and α-thalassemia). Further, only 2% had low iron stores (ferritin < 15 μg/L) and the prevalence of iron deficiency anemia was ∼14% in women with a hemoglobinopathy, compared to only ∼1.5% in women without a hemoglobinopathy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Improved Sanitation Facilities are Associated with Higher Body Mass Index and Higher Hemoglobin Concentration Among Rural Cambodian Women in the First Trimester of Pregnancy

Janmohamed

Karakochuk

McLean

et al. 2016

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

Abstract. Multiple factors contribute to undernutrition in Cambodian women. Our aim was to determine if type of household sanitation facility was associated with body mass index (BMI) and hemoglobin (Hb) concentration among pregnant women. Women (N = 544) from 75 villages in Kampong Chhnang Province had their height, weight, and Hb measured (HemoCue Hb 201 + ) in the first trimester. Sociodemographic and household characteristics were collected. Multivariable linear and logistic regression models were used for analyses. Approximately 40% (N = 221) of women reported primarily using an 'improved' sanitation facility (closed pit latrine) and ∼60% (N = 323) used 'non-improved' facilities (open defecation). Mean ± standard deviation (SD) BMI was higher among women with improved versus non-improved facilities (19.9 ± 3.0 kg/m 2 versus 19.4 ± 2.3 kg/m 2 ; P = 0.01). Mean ± SD Hb concentration was also higher among women with improved versus non-improved facilities (118 ± 12 g/L versus 114 ± 14 g/L; P = 0.001). Anemia prevalence (Hb < 110 g/L) was higher among women with non-improved facilities (34% versus 25%; P = 0.04). An improved sanitation facility was a positive predictor of BMI (β = 0.57 kg/m 2 ; 95% confidence interval [CI] = 0.10, 1.04) and Hb concentration (β = 2.94 g/L; 95% CI = 0.53, 5.35), adjusting for age, parity, household size, village, gestation week, source of drinking water, and iron folic acid supplementation. Poor sanitation was associated with lower BMI and Hb concentration among pregnant Cambodian women. This warrants multisectoral approaches involving the health, nutrition, water, and sanitation sectors to effectively improve maternal health in Cambodia.

show abstract

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Improved Sanitation Facilities are Associated with Higher Body Mass Index and Higher Hemoglobin Concentration Among Rural Cambodian Women in the First Trimester of Pregnancy

Janmohamed

Karakochuk

McLean

et al. 2016

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

show abstract

“…Deworming treatment in both groups likely minimized the risk of anemia due to helminth infection. The randomized design of the study controlled for unmeasured confounders such as genetic hemoglobin disorders, which are known to contribute to anemia in Cambodian women (34).…”

Section: Discussionmentioning

confidence: 99%

Prenatal supplementation with Corn Soya Blend Plus reduces the risk of maternal anemia in late gestation and lowers the rate of preterm birth but does not significantly improve maternal weight gain and birth anthropometric measurements in rural Cambodian women: a randomized trial

Janmohamed

Karakochuk

Boungnasiri³

et al. 2016

The American Journal of Clinical Nutrition

Self Cite

View full text Add to dashboard Cite

Background: Corn Soya Blend (CSB) Plus is a fortified dietary supplement used to help Cambodian women meet their nutritional requirements in pregnancy, although little is known about its ability to improve pregnancy outcomes. Objective: This study assessed the effect of prenatal CSB Plus supplementation on birth weight and secondary outcomes of low birth weight (,2500 g), small for gestational age, birth length and head circumference, preterm birth (,37 wk), maternal weight gain, and anemia at 24-28 wk, 30-32 wk, and 36-38 wk of gestation among rural Cambodian women. Design: A cluster-randomized trial was conducted in 75 villages in Kampong Chhnang Province, in which 547 women received CSB Plus (treatment) during the first trimester until delivery or continued their normal diet (control) based on their village residence. All women received routine daily iron folic acid tablets and were treated with additional iron folic acid if they were anemic (hemoglobin ,11 g/dL). Cluster-adjusted linear mixed-effect and logistic regression models were used to examine group differences. Results: There was no significant difference in birth weight between the CSB Plus and control group (46 g; 95% CI: 231, 123 g; P = 0.24). Significant reductions were observed in preterm birth (OR = 0.33; 95% CI: 0.12, 0.89) and anemia at 36-38 wk (OR = 0.51; 95% CI: 0.34, 0.77). There were no significant differences in low birth weight, small for gestational age, birth length, head circumference, or maternal weight gain. A higher rate of fetal loss was observed in the treatment group (10.2% compared with 3.7%; P , 0.01). Conclusions: In Cambodian women, CSB Plus consumed during pregnancy did not significantly increase maternal weight gain or improve birth size but did reduce maternal anemia in late gestation and preterm birth in comparison with women consuming a normal diet. The unexpectedly higher rate of fetal loss in the treatment group is concerning and warrants further investigation. This trial was registered at clinicaltrials.gov as NCT01413776.Am J Clin Nutr 2016;103:559-66.

show abstract

“…1 (31). These disorders can also cause anemia, so it's important to know the cause of anemia in order to determine proper treatment.…”

Section: The Way Forwardmentioning

confidence: 99%

Micronutrient Fortification of Food: Issues for Asia

Smith

2015

J Nutr Sci Vitaminol

View full text Add to dashboard Cite

Genetic Hemoglobin Disorders Rather Than Iron Deficiency Are a Major Predictor of Hemoglobin Concentration in Women of Reproductive Age in Rural Prey Veng, Cambodia,

Abstract: Multiple biomarkers for anemia and iron deficiency were significantly influenced by the presence of hemoglobin disorders, hence reducing their diagnostic sensitivity. Further investigation of the unexpectedly low prevalence of IDA in Cambodian women is warranted.

Cited by 63 publications

References 42 publications

Improved Sanitation Facilities are Associated with Higher Body Mass Index and Higher Hemoglobin Concentration Among Rural Cambodian Women in the First Trimester of Pregnancy

Improved Sanitation Facilities are Associated with Higher Body Mass Index and Higher Hemoglobin Concentration Among Rural Cambodian Women in the First Trimester of Pregnancy

Prenatal supplementation with Corn Soya Blend Plus reduces the risk of maternal anemia in late gestation and lowers the rate of preterm birth but does not significantly improve maternal weight gain and birth anthropometric measurements in rural Cambodian women: a randomized trial

Micronutrient Fortification of Food: Issues for Asia

Contact Info

Product

Resources

About