Skip to main content Skip to main navigation menu Skip to site footer

Haemoglobin Level of Pregnant Women was Associated with History of Anemia During Adolescent Period: Findings from the Indonesia Family Life Survey

Abstract

Introduction: Low hemoglobin levels in pregnant women are global health problem that adversely affect the mother’s and newborn’s health. There is no study proving the effect of anemia during adolescence in pregnancy, especially in Indonesian population. This study aimed to investigate the effect of anemia in adolescence on the hemoglobin level during pregnancy, using Indonesian Family Life Survey (IFLS) data.

Methods: This retrospective cohort study used the 1997, 2007 and 2014 IFLS data. The hemoglobin levels in adolescents aged 10-18 years were obtained from the IFLS-II data in 1997. Then, the hemoglobin levels during pregnancy from the same individuals were tracked from the IFLS-IV in 2007 and IFLS-V in 2014. Data from 210 subjects were included in the analysis as these subjects had the complete data on hemoglobin levels during adolescence and pregnancy and all other considered confounding variables, such as maternal age, iron protein, vitamin C consumption, education, working status, residence, socioeconomic status, gestational age at data collection, parity, antenatal care, iron supplement consumption. Data was analyzed by T tests, Pearson’s correlation tests and General Linear Model.

Results: The mean hemoglobin levels of pregnant women was 11.23 g/dL with standard deviation 1.271 and the prevalence of anemia during adolescence was 34.3%. There was a significant difference of 0.447 g/dL in the average hemoglobin levels in pregnant women with and without history of anemia during adolescence (p=0.023). The hemoglobin levels in pregnant women also differed among trimesters of gestational age (p=0.001). After being controlled for vitamin C and protein consumption, anemia status during adolescence still has a significant effect on lowering hemoglobin level during pregnancy.

Conclusion: Anemia during adolescence negatively impacts pregnant women's hemoglobin levels. Prevention programs for anemia in pregnant women should be started from adolescence period.

References

  1. Kraemer K, Zimmermann MB. Nutritional anemia. Sight and Life Press. Basel: Sight and Life Press; 2007.
  2. World Health Organization. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Geneva; 2011.
  3. World Health Organization. WHO Global Anaemia estimates, 2021 Edition. World Health Organization. 2021.
  4. Andriani L, Nugrahmi MA, Amalia M, Yunura I. Pendidikan Kesehatan tentang Gizi dan Pengaruh Anemia pada Remaja di SMK Muhammadiyah Kota Bukittinggi. J Salingka Abdimas. 2021;1(1):18–21.
  5. Arisman. Gizi dalam Daur Kehidupan. dua. Suryani, editor. Jakarta: Penerbit Buku Kedokteran EGC; 2008. 275 p.
  6. Randall DA, Patterson JA, Gallimore F, Morris JM, McGee TM, Ford JB. The Association between Haemoglobin Levels in the First 20 Weeks of Pregnancy and Pregnancy Outcomes. PLoS One. 2019;14(11):e0225123.
  7. Drukker L, Hants Y, Farkash R, Ruchlemer R, Samueloff A, Grisaru-Granovsky S. Iron Deficiency Anemia at Admission for Labor and Delivery is Associated with an Increased Risk for Cesarean Section and Adverse Maternal and Neonatal Outcomes. Transfusion. 2015;55(12):2799–806.
  8. Amir AN, Anggraini ML, Jessica F. Analisis Faktor-faktor yang Mempengaruhi Kadar Hb Ibu Hamil di Wilayah Kerja Puskesmas Andalas Kota Padang. J Kesehat Saintika Meditory. 2020;4(1):1–8.
  9. Young MF. Maternal Anaemia and Risk of Mortality : A Call for Action. Lancet Glob Heal. 2018;6(5):E479–80.
  10. Rahman M, Abe SK, Rahman S, Kanda M, Narita S, Bilano V, et al. Maternal Anemia and Risk of Adverse Birth and Health Outcomes in Low- and Middle-Income Countries: Systematic Review and Meta-Analysis. Am J Clin Nutr. 2016;103(2):495–504.
  11. Daru J, Zamora J, Fernandez-Felix BM, Vogel J, Oladapo OT, Morisaki N, et al. Risk of Maternal Mortality in Women with Severe Anaemia during Pregnancy and Post Partum : A Multilevel Analysis. Lancet Glob Heal. 2018;6(5):E548–54.
  12. Shi H, Chen L, Wang Y, et al. Severity of Anemia During Pregnancy and Adverse Maternal and Fetal Outcomes. Obstet Gynecol. 2022;5(2):1–13.
  13. Sungkar A, Bardosono S, Irwinda R, Manikam NRM, Sekartini R, Medise BE, et al. A Life Course Approach to the Prevention of Iron Deficiency Anemia in Indonesia. Nutrients. 2022;14(277):1–8.
  14. Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life. Nutrients. 2022;14(18):1–13.
  15. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, Prenatal Iron Use, and Risk of Adverse Pregnancy Outcomes : Systematic Review and Meta-Analysis. BMJ. 2013;346:f3443.
  16. Kuma MN, Tamiru D, Belachew T. Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia. BioMed Res Intenational. 2021;2021(9922370).
  17. Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G. Iron Deficiency Anemia in Pregnancy : Novel Approaches for an Old Problem. Oman Med J. 2020;35(5):166.
  18. Tran TD, Biggs B-A, Tran T, Simpson JA, Hanieh S, Dwyer T, et al. Impact on Infants’ Cognitive Development of Antenatal Exposure to Iron Deficiency Disorder and Common Mental Disorders. PLoS One. 2013;8(9):1–9.
  19. Radlowski EC, Johnson RW. Perinatal Iron Deficiency and Neurocognitive Development. Front Hum Neurosci. 2013;7:1–11.
  20. Tampy ST, Nugroho HW, Syuadzah R, Kartikawati D. The Associations between Anemia, Stunting, Low Birthweight, and Cognitive Ability in Indonesian Children: An Analysis from Indonesian Family Life Survey. J Matern Child Heal. 2020;05(04):402–12.
  21. Sirajuddin S, Masni. Kejadian Anemia pada Siswa Sekolah Dasar. Kesmas J Kesehat Masy Nas. 2015;9(3):264–9.
  22. Tezera R, Sahile Z, Yilma D, Misganaw E, Mulu E. Prevalence of Anemia among School-age Children in Ethiopia : A Systematic Review and Meta-analysis. BMC. 2018;7(80):1–7.
  23. World Health Organization. WHO Guidance Helps Detect Iron Deficiency and Protect Brain Development. World Health Organization. 2020.
  24. World Health Organization. Anaemia. World Health Organization. 2020.
  25. The Global Health Observatory. Prevalence of Anaemia in Non-Pregnant Women (Aged 15-49) (%). World Health Organization. 2021.
  26. World Health Organization. WHO Recommendations on Antenatal Care for A Positive Pregnancy Experience. Luxembourg: World Health Organization; 2016.
  27. World Health Organization. Nutritional Anaemias : Tools for Effective Prevention and Control. Geneva: World Health Organization; 2017.
  28. Kementerian Kesehatan. Hasil Utama RISKESDAS 2018. Jakarta; 2018.
  29. World Health Organization. Prevalence of Anaemia in Pregnant Women (Aged 15-49) (%). World Health Organization. 2021.
  30. Sikoway S, Mewo Y, Assa Y. Gambaran Kadar Hemoglobin pada Ibu Hamil Trimester III di Rumah Sakit Robert Wolter Mongisidi Manado. Med Scope J. 2020;1(2):82–5.
  31. Nurhidayati A, Hapsari E. Hubungan Asupan Nutrisi dengan Kadar Hb pada Ibu Hamil di BPS Suratini Suwarno Surakarta. J Kesehat Kusuma Husada. 2014;5(1).
  32. Badan Penelitian dan Pengembangan Kesehatan. Laporan Nasional Riskesdas 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan; 2019.
  33. Steketee RW. Pregnancy, Nutrition and Parasitic Diseases. Infect Inflamm. 2003;1661s-1667s.
  34. Brown JE, Isaacs JS, Krinke UB, Lechtenberg E, Murtaugh MA, Sharbaugh C, et al. Nutrition Through the Life Cycle. Sixth Edit. Wadsworth: Cengage Learning; 2013.
  35. Cerf ME. Healthy Lifestyles and Noncommunicable Diseases : Nutrition, the Life-Course, and Health Promotion. Lifestyle Med. 2021;2(e31):1–12.
  36. Lynch SR. The Potential Impact of Iron Supplementation during Adolescence on Iron Status in Pregnancy. Am Soc Nutr Sci. 2000;448S-451S.
  37. Liu X, An H, Li N, Li Z, Zhang Y, Zhang L, et al. Preconception Hemoglobin Concentration and Risk of Low Birth Weight and Small-for-Gestational-Age: A Large Prospective Cohort Study in China. Nutrients. 2022;14(271).
  38. Yi S-W, Han Y-J, Ohrr H. Anemia Before Pregnancy and Risk of Preterm Birth, Low Birth Weight and Small-for-gestational-age Birth in Korean Women. Eur J Clin Nutr. 2013;67:337–42.
  39. Gonzalez-Casanova I, Nguyen P, Hao W, Pham H, Truong T, Nguyen S, et al. Preconception Anemia and Birth Outcomes in Vietnam. FASEB J. 2014;28(S1).
  40. Eteffa T, Arega A, Abejie B, Feyisa W, Alemnew F, Asme A, et al. Prevalence of Anemia and its Associated Factors among Antenatal Care Attendees in the Public Health Facilities of Pawi District, Northwest, Ethiopia, 2020. J Nutr Med Diet Care. 2022;8(059).
  41. Fite MB, Assefa N, Mengiste B. Prevalence and Determinants of Anemia among Pregnant Women in sub-Saharan Africa: A Systematic Review and Meta-analysis. Arch Public Heal. 2021;79:219.
  42. Chandra S, Tripathi AK, Mishra S, Amzarul M, Vaish AK. Physiological Changes in Hematological Parameters During Pregnancy. Indian J Hematol Blood Transfus. 2012;28(3):144–6.
  43. Husna A, Safitri F, Kasmanila. Faktor yang Berhubungan dengan Kejadian Anemia pada Ibu Hamil di Wilayah Kerja Puskesmas Peukan Bada Aceh Besar. J Healthc Technol Med. 2021;7(1):263–71.
  44. Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G. Iron Deficiency Anemia in Pregnancy: Novel Approaches for an Old Problem. Oman Med J. 2020;35(5):E166.
  45. Madaan G, Bhardwaj AK, Narang S, Sharma P. Effects of Third Trimester Maternal Hemoglobin Upon Newborn Anthropometry. J Nepal Paediatr Soc. 2013;33(3):186–9.
  46. Kumar KJ, Asha N, Murthy DS, Sujatha M, Manjunath V. Maternal Anemia in Various Trimesters and its Effect on Newborn Weight and Maturity: An Observational Study. Int J Prev Med. 2013;4(2):193–9.
  47. Wahyuna R, Wahyuni Y, Swamilaksita PD. Hubungan Asupan Protein, Fe, Vitamin C dan Serat terhadap Kadar Hb pada Ibu Hamil Penerima BPJS di Wilayah Kerja Puskesmas Kecamatan Kebon Jeruk Tahun 2017. J Esa Unggul. 2017.
  48. Utari J, Nuzrina R, Nadiyah. Correlation of Energy Intake, Protein and Micronutrients with Hemoglobin Levels of Pregnant Women in Puskesmas Kecamatan Kebon Jeruk. J Esa Unggul. 2019;1–12.
  49. Retnaningsih Y, Sulistyani IA, Purnamamingrum YE, Margono, Estiwidani D. Hubungan Asupan Protein, Fe, Vitamin C Serta Ketepatan Konsumsi Zat Tannin Dan Kafein Terhadap Kadar Hemoglobin Ibu Hamil Trimester III Di Puskesmas Kota Yogyakarta. J Nutr. 2020;22(1):8–15.
  50. Jasnidar A. Hubungan Asupan Protein dengan Kejadian Anemia pada Ibu Hamil Trimester III di WIlayah Kerja Puskesmas Lubuk Kilangan Kota Padang. Universitas Andalas; 2021.
  51. Fitriani S, Pamungkasari EP, Suminah. Correlation between Protein Intake, Parity and Miscarriage History Anemic Pregnant Women in Sukoharjo Regency, Indonesia with Low Birth Weight Incidence: A Case Control Study. Indian J Public Heal Res Dev. 2020;11(01):1550–4.
  52. Pineng P. Hubungan antara Asupan Protein dengan Kadar Hemoglobin pada Ibu Hamil Trimester III di Puskesmas Ranomuut Kota Manado. J Fak Kesehat Masy Univ Sam Ratulangi Manad. 2015;
  53. Fera D, Duana M, Putri ES. The Relationship Between Adequacy of Animal Protein Consumption and Hemoglobin Levels for Pregnant Women. JNS J Nutr Sci. 2021;2(1):1–6.
  54. Siallagan D, Swamilaksita PD, Angkasa D. Pengaruh Asupan Fe, Vitamin A, Vitamin B12, dan Vitamin C terhadap Kadar Hemoglobin pada Remaja Vegan. J Gizi Klin Indones. 2016;13(2).
  55. Triswanti, Maghfiroh T. The Difference Of Effectiveness Way To Consume Iron Tablets Toward Haemoglobin Level Changes to Pregnant Women In Second Trimester at The Sindang Barang Community Health Center In 2017. J Nurs Pract. 2020;3(2):188–92.
  56. Novelia S, Dewi A, Melinasari S, Widowati R, Carolin BT. Iron and Orange Extract on Hemoglobin among Anemic Pregnant Women in Nusa Tenggara Barat in 2018. Asian Community Heal Nurs Res. 2020;2(1):8–12.
  57. Agusmayanti R, Farich A, Anggraini. Pemberian Vitamin C dapat Meningkatkan Kadar Hemoglobin pada Ibu Hamil Anemia. J Kebidanan. 2020;6(3):342–8.
  58. Kurz KM, Galloway R. Improving Adolescent Iron Status before Childbearing. Am Soc Nutr Sci. 2000;130:437S-439S.

How to Cite

Handari, S. R. T., Anies, Martha Irene Kartasurya, & Sri Achadi Nugraheni. (2022). Haemoglobin Level of Pregnant Women was Associated with History of Anemia During Adolescent Period: Findings from the Indonesia Family Life Survey. Bali Medical Journal, 11(3), 1710–1716. https://doi.org/10.15562/bmj.v11i3.3783

HTML
0

Total
2

Share

Search Panel

Siti Riptifah Tri Handari
Google Scholar
Pubmed
BMJ Journal


Anies
Google Scholar
Pubmed
BMJ Journal


Martha Irene Kartasurya
Google Scholar
Pubmed
BMJ Journal


Sri Achadi Nugraheni
Google Scholar
Pubmed
BMJ Journal