Maternal Micronutrient Supplementation and Long Term Health Impact in Children in Rural Bangladesh

Mannan, Tania; Ahmed, Sultan; Akhtar, Evana; Roy, Anjan Kumar; Haq, Md. Ahsanul; Roy, Adity; Kippler, Maria; Ekström, Eva‐Charlotte; Wagatsuma, Yukiko; Raqib, Rubhana

doi:10.1371/journal.pone.0161294

Cited by 11 publications

(11 citation statements)

References 34 publications

(36 reference statements)

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“…The global prevalence of anemia among children under 5 years of age is about 43% [2]. It may adversely influence the mental development, physical growth and social behavior in young children [3–6]. In older children, it may be associated with negative behavior, poor school performance and low work capacity [7].…”

Section: Introductionmentioning

confidence: 99%

Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

et al. 2019

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Background Anemia is not only a major public health problem among children in developing countries, it is also an important predictor for their future growth and development. The objective of this study was to identify possible factors associated with anemia among pre-school children in Bangladesh after removing a cluster effect of the population, and to determine the prevalence of this condition. Methods Data for this study was extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS-2011). In this survey, data was collected using a two-stage stratified cluster sampling approach. The chi-square test and a two-level logistic regression model were used for further analysis. Results Data from 2231 children aged 6–59 months were included for analysis. The prevalence of child anemia was noted to be 52.10%. Among these anemic children, 48.40% where from urban environment and 53.90% were from rural areas. The prevalence of mild, moderate and severe anemia among children was 57.10, 41.40 and 1.50% respectively. The two-level logistic regression model revealed that the following factors were associated with childhood anemia: children of anemic mothers ( p < 0.01), undernourished children ( p < 0.05), younger children (age < 2 years) ( p < 0.01) and children from poor family ( p < 0.05). Lastly, anemia was more common among children living in Barisal and Rangpur divisions compared to those from Dhaka division ( p < 0.01), and among non-Muslims than Muslim ( p < 0.05). Conclusions Our study showed that prevalence of anemia among pre-school children in Bangladesh was very high (52.10%). We noted that young children of anemic mothers, from poor families, and being undernourished were at higher risk of developing anemia. Since most of these risk factors were related to socioeconomic conditions, they were potentially modifiable. Therefore, our findings may be useful for the health authorities to identify children at risk for remedial action and to plan for preventive measures.

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Section: Introductionmentioning

confidence: 99%

Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

et al. 2019

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“…2014). The present study included 551 of the 640 children, who were followed up again at 9 y of age (Mannan et al. 2016) and who provided a urine and/or blood sample to be analyzed for cadmium (see Figure S1).…”

Section: Methodsmentioning

confidence: 99%

Early-Life Cadmium Exposure and Bone-Related Biomarkers: A Longitudinal Study in Children

Igra

Vahter

Raqib

et al. 2019

Environ Health Perspect

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Background:Chronic cadmium exposure has been associated with osteotoxicity in adults, but little is known concerning its effects on early growth, which has been shown to be impaired by cadmium.Objectives:Our objective was to assess the impact of early-life cadmium exposure on bone-related biomarkers and anthropometry at 9 y of age.Methods:For 504 children in a mother–child cohort in Bangladesh, cadmium exposure was assessed by concentrations in urine (U-Cd, long-term exposure) and erythrocytes (Ery-Cd, ongoing exposure) at 9 and 4.5 y of age, and in their mothers during pregnancy. Biomarkers of bone remodeling [urinary deoxypyridinoline (DPD), urinary calcium, plasma parathyroid hormone, osteocalcin, vitamin D3, insulin-like growth factor (IGF) 1, IGF binding protein 3, thyroid stimulating hormone] were measured at 9 y of age.Results:In multivariable-adjusted linear models, a doubling of concurrent U-Cd was associated with a mean increase in osteocalcin of 2.7 ng/mL (95% CI: 0.042, 5.9) and in urinary DPD of 22 nmol/L (95% CI: 12, 32). In a combined exposure model, a doubling of maternal Ery-Cd was associated with a mean increase in urinary DPD of 15 nmol /L (95% CI: −0.047, 30). Stratifying the osteocalcin model by gender (pinteraction= 0.001), a doubling of concurrent U-Cd was associated with a mean decrease in osteocalcin of −4.3 ng/mL (95% CI: −8.5, −0.080) in boys and a mean increase of 9.4 ng/mL (95% CI: 5.4, 13) in girls. The same pattern was seen with U-Cd at 4.5 y of age (pinteraction= 0.016). Children’s U-Cd and Ery-Cd, concurrent and at 4.5 y of age, were inversely associated with vitamin D3.Conclusions:Childhood cadmium exposure was associated with several bone-related biomarkers and some of the associations differed by gender. https://doi.org/10.1289/EHP3655

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“…At the follow-up of the children at 10 years of age ( Rahman et al 2016 ), we collected hair samples for measurement of concentrations of multiple toxic and essential elements (Mg, Ca, Mn, Fe, Co, Cu, Zn, As, Se, Mo, Cd, and Pb). For evaluation of their use as exposure biomarkers (internal dose), we compared these with previously measured concentrations of the elements in blood (erythrocyte fraction) and urine ( Ahmed et al 2014 ), collected on average

earlier (median 6 months) ( Mannan et al 2016 ). In total, 207 children had complete data for all biospecimens.…”

Section: Methodsmentioning

confidence: 99%

Major Limitations in Using Element Concentrations in Hair as Biomarkers of Exposure to Toxic and Essential Trace Elements in Children

Skröder

Kippler

Nermell

et al. 2017

Environ Health Perspect

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Background:Hair is a commonly used exposure biomarker for metals and other trace elements, but concern has been raised regarding its appropriateness for assessing the internal dose.Objectives:The aim of the present study was to evaluate children’s hair as biomarker of internal dose for toxic (As, Mn, Cd, Pb) and essential elements (Mg, Ca, Fe, Co, Cu, Zn, Se, Mo).Methods:In 207 children (9–10 years of age), originating from a population-based cohort in rural Bangladesh, we measured concentrations of the selected elements in hair (2cm closest to the scalp) using ICP-MS. We compared these with previously measured concentrations in erythrocytes, urine, and water. For a subset of children (n=19), we analyzed four consecutive 2cm pieces of hair.Results:There were strong associations between hair As and the other biomarkers (erythrocytes: rnormalS=0.73, p<0.001; urine: rnormalS=0.66, p<0.001); and water (rnormalS=0.60, p<0.001); and there were significant correlations between Se in hair and erythrocytes (overall rnormalS=0.38, p<0.001), and urine (rnormalS=0.29, p<0.001). Hair Co and Mo showed weak correlations with concentrations in erythrocytes. Hair Mn was not associated with Mn in erythrocytes, urine, or water, and the geometric mean concentration increased almost five times from the 2cm closest to the head to the 7th–8th cm (p<0.001). Also Mg, Ca, Co, Cd, and Pb increased from the scalp outward (>50% higher in 7th–8th cm compared with 1st–2nd cm, p<0.001).Conclusions:Hair was found to be a useful exposure biomarker of absorbed As and Se only. Of all measured elements, hair Mn seemed the least reflective of internal dose. https://doi.org/10.1289/EHP1239

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Maternal Micronutrient Supplementation and Long Term Health Impact in Children in Rural Bangladesh

Cited by 11 publications

References 34 publications

Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

Early-Life Cadmium Exposure and Bone-Related Biomarkers: A Longitudinal Study in Children

Major Limitations in Using Element Concentrations in Hair as Biomarkers of Exposure to Toxic and Essential Trace Elements in Children

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