Table 3.
Association of anemia group with adverse maternal hematologic and neonatal outcomes among HIV-negative pregnant women in the placebo arm of a randomized trial in Dar es Salaam, Tanzania, 2010–2013 (N = 724)
| Delivery outcome | Total, n = 724 | No anemia at baseline, n = 538 | Non-iron deficiency anemia (NIDA) at baseline, n = 108 | Iron deficiency anemia (IDA) at baseline, n = 78 | p-value for NIDA vs IDA | |||||
|---|---|---|---|---|---|---|---|---|---|---|
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| n (%) or mean (95% CI) | n (%) or mean (95% CI) | Adjusted RR or MD (95% CI)2, 3, 4 | n (%) or mean (95% CI) | Adjusted RR or MD (95% CI)2, 3, 4 | p-value | n (%) or mean (95% CI) | Adjusted RR or MD (95% CI)2, 3, 4 | p-value | ||
|
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| Maternal | ||||||||||
| Delivery hemoglobin, g/L, N = 483 | 109 (107, 111) | 112(110, 114) | Ref | 106 (102, 110) | −7.3 (−11.5, −3.1) | <0.001 | 96 (92, 101) | − 15.0 (−19.3, −10.9) | <0.001 | 0.005 |
| Anemia< 110 g/L | 49.9% | 42.4% | Ref | 61.3% | 1.42 (1.00, 1.99) | 0.05 | 84.6% | 1.97 (1.37, 2.79) | <0.001 | 0.13 |
| Moderate anemia < 100 g/L | 26.7% | 21.3% | Ref | 34.7% | 1.73 (1.06,2.74) | 0.02 | 51.9% | 2.50 (1.53, 4.00) | <0.001 | 0.18 |
| Severe anemia <70 g/L | 2.9% | 2.2% | Ref | 2.7% | 2.37 (0.45, 12.5) | 0.31 | 7.7% | 4.49 (1.05, 19.1) | 0.04 | 0.42 |
| Delivery ferritin, μg/L, N = 476 | 41.1 (37.4,44.7) | 42.0 (37.7, 46.3) | Ref | 39.0 (31.6,46.3) | 0.1 (−5.8, 6.0) | 0.64 | 38.2(25.0,51.5) | −3.6 (−9.4, 2.3) | 0.23 | 0.34 |
| ID at delivery | 73.2% | 74.0% | Ref | 65.8% | 0.90 (0.65, 1.22) | 0.50 | 78.8% | 1.07 (0.75, 1.50) | 0.72 | 0.44 |
| Anemia type, N = 472 | ||||||||||
| IDA, N = 176 | 37.3% | 33.2% | Ref | 38.4% | Ref | 64.0% | Ref | 0.004 | ||
| NIDA, N = 54 | 11.4% | 8.0% | Ref | 21.9% | 3.05 (1.34, 6.93) | 0.008 | 20.0% | 1.34 (0.53,3.37) | 0.54 | |
| Placental malaria, any, N = 493 | 6.5% | 6.4% | Ref | 7.6% | 1.29 (0.51, 3.28) | 0.72 | 5.5% | 0.80 (0.23, 2.80) | 0.59 | 0.49 |
| Submicroscopic | 4.7% | 4.5% | Ref | 7.6% | 1.94 (0.72, 5.23) | 0.23 | 1.8% | 0.27 (0.03, 2.23) | 0.19 | 0.04 |
| Microscopic | 2.0% | 1.9% | Ref | 1.3% | 0.74 (0.08, 6.63) | 0.82 | 3.6% | 3.23 (0.50, 21.0) | 0.22 | 0.24 |
| Newborn | ||||||||||
| Stillbirths, N = 702 | 4.7% | 3.8% | Ref | 3.9% | 1.34 (0.37, 3.78) | 0.61 | 10.3% | 3.10(1.16, 7.67) | 0.02 | 0.19 |
| Perinatal mortality, N = 702 | 6.3% | 5.4% | Ref | 5.8% | 1.23 (0.45, 2.91) | 0.66 | 12.8% | 2.61 (1.14, 5.61) | 0.02 | 0.17 |
| Neonatal mortality, N = 669 | 2.2% | 2.2% | Ref | 1.9% | 0.86 (0.18, 4.08) | 0.85 | 2.9% | 1.25 (0.26, 6.05) | 0.78 | 0.74 |
| Low birth weight, N = 636 | 11.8% | 12.4% | Ref | 10.6% | 0.73 (0.34, 1.39) | 0.36 | 8.7% | 0.64 (0.24, 1.43) | 0.32 | 0.79 |
| SGA, N = 635 | 16.4% | 18.8% | Ref | 8.5% | 0.40(0.18,0.79) | 0.02 | 10.1% | 0.54 (0.22, 1.11) | 0.13 | 0.62 |
| Birth weight, g, N = 636 | 3130 (3089, 3172) | 3133 (3084, 3183) | Ref | 3090 (2987, 3194) | 36 (−60, 132) | 0.46 | 3163 (3047, 3280) | 79 (−38, 195) | 0.18 | 0.57 |
| GA at delivery, weeks, N = 702 | 39.2 (39.0, 39.5) | 39.4 (39.1,39.5) | Ref | 38.5 (37.8, 39.1) | −0.7 (−1.4, −0.1) | 0.02 | 39.0(38.2, 39.8) | − 0.3 (−1.0, 0.4) | 0.43 | 0.20 |
| Preterm | 18.1% | 16.7% | Ref | 23.3% | 1.54 (0.94,2.45) | 0.07 | 20.5% | 1.40 (0.77, 2.42) | 0.24 | 0.78 |
| Very preterm | 2.7% | 1.5% | Ref | 4.9% | 3.08 (0.87, 10.1) | 0.07 | 7.7% | 4.42 (1.27, 14.2) | 0.01 | 0.62 |
Values in the column are the number of outcome events/number of observations (n/N) or mean (95% CI)
Values in the column are relative risks (RR) or mean difference (MD), with 95% confidence intervals
Log-Poisson regression models estimated to obtain the RR of critical pregnancy outcomes. RR > 1 implies the pregnancy outcome is more likely to occur among those who meet the definition of anemia of inflammation at baseline. RR < 1 implies the pregnancy outcome is less likely. Linear regression models estimated mean differences, reported with robust confidence intervals
Multivariable estimates were adjusted for age (18–20, 21–25 and > 25 years), and parity (0, 1), gestational age at enrollment (continuous, weeks), BMI (continuous, kg/m2), meat consumption (< 90 g, ≥ 90 g per week), number of household assets (0–5, 6–8, 9–10),and infant sex (male, female)