Maternal hemoglobin concentrations across pregnancy and child health and development from birth through 6–7 years

Abstract

BackgroundThe role of changes in maternal hemoglobin (Hb) across pregnancy on child health and development (CHD) remains unclear.ObjectiveWe 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.MethodsWe 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.ResultsFour 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.ConclusionMaternal 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.

Associations between diet quality and dietary patterns and gestational diabetes mellitus in a low‐risk cohort of pregnant women in Australia: a cross‐sectional study

“…This study analysed data from the first visit (15 ± 3 weeks gestation) and the fifth visit (35 ± 2 weeks gestation). We defined these time points as early and late pregnancy stages that align with commonly used terms in the literature to describe the distinct stages of pregnancy 29–32 . As a standard practice in Australia, blood glucose is monitored between 24 and 28 weeks of gestation 33 .…”

“…We defined these time points as early and late pregnancy stages that align with commonly used terms in the literature to describe the distinct stages of pregnancy. [29][30][31][32] As a standard practice in Australia, blood glucose is monitored between 24 and 28 weeks of gestation. 33 After standard clinical care, CPO participants underwent an oral glucose tolerance test (OGTT) between 24 and 28 weeks gestation.…”