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Maternal Pre-pregnancy Anemia and Child Anemia in Indonesia: Risk Assessment Based on a Population-Based Prospective Longitudinal Study

Wirawan Fadila|Nurrika Dietta
한국역학회 (Korean Society of Epidemiology)|2022.01|Epidemiology and Health|제44권 |pp. 1-11|DOI 10.4178/epih.e2022100

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키워드

PregnancyChildPreschoolAnemiaPreconception careMaternal healthIron-deficiency

초록

OBJECTIVES: Under 5 years old (under-5) anemia is overlooked despite its detrimental effect. The approach to anemia prevention has been extended to maternal pre-pregnancy phase. This research is aimed to analyze pre-pregnancy anemia association and risk of anemia in under-5 children. METHODS: This cohort study observed non-pregnant women in the Indonesian Family Life Survey (IFLS) 2007 and their under-5 children in the IFLS 2014. Anemia status was determined based on Hemoglobin (Hb) measurement using HemocueTM in mothers and children. Mantel-Haenszel adjusted relative risk (aRR) analysis including risk stratification by the covariates was used to get final risk assessment. RESULTS: A total of 637 under-5 children in the IFLS 2014 were included. The risk of having under-5 child with anemia increased 1.71-fold in women with pre-pregnancy anemia compared to women without pre-pregnancy anemia (aRR= 1.71, 1.03- 2.85 95% CI). After risk stratification based on the potential confounding variables, maternal pre-pregnancy anemia is still an independent risk of under-5 anemia in child that still breastfed at the time of data collection (RR= 2.11, 1.16-3.86 95% CI), in child that fed water earlier than 6 months old (RR= 2.08, 1.20-3.61 95% CI), in child of mother with normal and underweight pre-pregnancy BMI (RR= 1.94, 1.20-3.14 95% CI), and in child of mother with no current anemia (RR= 2.20, 1.21-3.99 95% CI). CONCLUSIONS: Pre-pregnancy anemia increased the risk of under-5 anemia based on Indonesian population study. Public health approach to extend maternal health provision to preconception phase would provide better maternal and child morbidity risk prevention.

Abstract

OBJECTIVES: Under 5 years old (under-5) anemia is overlooked despite its detrimental effect. The approach to anemia prevention has been extended to maternal pre-pregnancy phase. This research is aimed to analyze pre-pregnancy anemia association and risk of anemia in under-5 children. METHODS: This cohort study observed non-pregnant women in the Indonesian Family Life Survey (IFLS) 2007 and their under-5 children in the IFLS 2014. Anemia status was determined based on Hemoglobin (Hb) measurement using HemocueTM in mothers and children. Mantel-Haenszel adjusted relative risk (aRR) analysis including risk stratification by the covariates was used to get final risk assessment. RESULTS: A total of 637 under-5 children in the IFLS 2014 were included. The risk of having under-5 child with anemia increased 1.71-fold in women with pre-pregnancy anemia compared to women without pre-pregnancy anemia (aRR= 1.71, 1.03- 2.85 95% CI). After risk stratification based on the potential confounding variables, maternal pre-pregnancy anemia is still an independent risk of under-5 anemia in child that still breastfed at the time of data collection (RR= 2.11, 1.16-3.86 95% CI), in child that fed water earlier than 6 months old (RR= 2.08, 1.20-3.61 95% CI), in child of mother with normal and underweight pre-pregnancy BMI (RR= 1.94, 1.20-3.14 95% CI), and in child of mother with no current anemia (RR= 2.20, 1.21-3.99 95% CI). CONCLUSIONS: Pre-pregnancy anemia increased the risk of under-5 anemia based on Indonesian population study. Public health approach to extend maternal health provision to preconception phase would provide better maternal and child morbidity risk prevention.

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