Table 2.
Association of maternal anaemia and hypochromic microcytosis with child mortality
| Hazard ratio (95% confidence interval) for child mortality | |||||
|---|---|---|---|---|---|
| # Events/Y | Unadjusted HR | P trend | Adjusted HR* | P trend | |
| Anaemia † | |||||
| Complete follow‐up ‡ | |||||
| Absent | 62/1786 | 1.00 | <0.0001 | 1.00 | <0.0001 |
| Moderate | 112/1185 | 2.16 (1.55, 3.01) | 1.81 (1.27, 2.57) | ||
| Severe | 51/278 | 3.81 (2.54, 5.70) | 2.58 (1.66, 4.01) | ||
| 0–11 months of age | |||||
| Absent | 22/139 | 1.00 | <0.0001 | 1.00 | 0.002 |
| Moderate | 76/182 | 3.26 (1.88, 5.65) | 2.22 (1.20, 4.08) | ||
| Severe | 39/58 | 5.29 (2.88, 9.69) | 2.97 (1.50, 5.87) | ||
| 12–23 months of age | |||||
| Absent | 23/387 | 1.00 | 0.0004 | 1.00 | 0.005 |
| Moderate | 21/239 | 1.82 (1.00, 3.29) | 1.57 (0.84, 2.93) | ||
| Severe | 9/49 | 4.18 (1.93, 9.06) | 3.78 (1.60, 8.93) | ||
| Hypochromic microcytosis † | |||||
| Complete follow‐up ‡ | |||||
| Absent | 128/2397 | 1.00 | <0.0001 | 1.00 | 0.001 |
| Mild | 62/607 | 1.78 (1.29, 2.47) | 1.58 (1.12, 2.33) | ||
| Moderate | 19/159 | 2.62 (1.57, 4.37) | 1.45 (0.80, 2.62) | ||
| Severe | 15/85 | 3.01 (1.69, 5.36) | 2.36 (1.27, 4.38) | ||
| 0–11 months of age | |||||
| Absent | 69/269 | 1.00 | <0.0001 | 1.00 | 0.002 |
| Mild | 44/80 | 2.53 (1.65, 3.88) | 2.02 (1.26, 3.24) | ||
| Moderate | 13/17 | 3.61 (1.88, 6.95) | 3.45 (1.50, 7.93) | ||
| Severe | 11/13 | 2.64 (1.29, 5.42) | 1.90 (0.83, 4.37) | ||
| 12–23 months of age | |||||
| Absent | 39/538 | 1.00 | 0.09 | 1.00 | 0.45 |
| Mild | 9/101 | 1.27 (0.62, 2.62) | 0.93 (0.41, 2.12) | ||
| Moderate | 3/24 | 1.70 (0.52, 5.50) | 1.05 (0.30, 3.62) | ||
| Severe | 2/12 | 3.17 (0.76, 13.18) | 3.02 (0.67, 13.58) | ||
Multivariate‐adjusted hazard ratio (HR) from a proportional hazards model adjusting for maternal age (<20, 20–24, 25–29, ≥30 years), body mass index at baseline (kg m−2), viral load at baseline (copies mm−3), CD4 at baseline (cells mL−1), World Health Organization clinical stage at baseline (1, 2–4), malaria infection at baseline, parity (0, 1–2, ≥3), prenatal compliance with iron and folic acid supplementation (percent of scheduled prenatal visits attended), regimen, and child HIV status (time‐varying).
Anaemia was categorised as absent: haemoglobin (Hb) ≥11.0 g dL−1; moderate: Hb from 8.5 to <11.0 g dL−1; and severe: Hb <8.5 g dL−1. Hypochromic microcytosis anaemia was categorised as absent: hypochromasia absent; mild: any hypochromasia without microcytosis; moderate: hypochromasia <25% and microcytic cells observed; or severe: hypochromasia ≥25% and microcytic cells observed.
‡ Median duration of complete follow‐up for the child mortality endpoint was 63 months (interquartile range: 19, 71).