title: The aetiology of anaemia during pregnancy: a study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women.
abstract: OBJECTIVE
  To describe the aetiology of anaemia in pregnant Ugandan women and explore Fe deficiency and common infections as contributors to anaemia in this population.
  
  
  METHODS
  Cross-sectional study in which Hb, ferritin, transferrin receptor (sTfR), C-reactive protein, α-1 acid glycoprotein, hepcidin, malaria, hookworm infestation, syphilis and Helicobacter pylori infection were assessed.
  
  
  METHODS
  Antenatal care clinic at Kawempe Health Centre, Kampala, Uganda.
  
  
  METHODS
  HIV-negative women (n 151) in their first or second pregnancy at 10-16 weeks' gestation.
  
  
  RESULTS
  The prevalence of anaemia was 29·1 %. Fe deficiency was 40·4 % and 14·6 % based on ferritin 8·3 μg/ml. The prevalence of Fe-deficiency anaemia was 9·3 % based on ferritin 8·3 μg/ml. Hepcidin concentration was positively correlated with ferritin concentration (n 151, r=0·578, P1 g/l and/or C-reactive protein >5 mg/l. Malaria parasitaemia (OR=6·85; 95 % CI 1·25, 37·41, P=0·026) and Fe deficiency defined using sTfR (OR=5·58; 95 % CI 1·26, 24·80, P=0·024) were independently and positively associated with anaemia. Population-attributable risk factors for anaemia for raised C-reactive protein, Fe deficiency defined by sTfR >8·3 μg/ml and presence of malaria parasites were 41·6 (95 % CI 11·1, 72·2) %, 13·5 (95 % CI 2·0, 25·0) % and 12·0 (95 % CI 1·4, 22·6) %, respectively.
  
  
  CONCLUSIONS
  Infections and inflammation are of greater significance than Fe deficiency in the aetiology of anaemia in pregnant Ugandan women during the first trimester.
authors.affiliation: 1Department of Biochemistry and Sports Science,College of Natural Sciences,Makerere University,PO Box 7062,Kampala,Uganda.
authors.forename: Rhona K
authors.initials: RK
authors.lastname: Baingana
authors.affiliation: 1Department of Biochemistry and Sports Science,College of Natural Sciences,Makerere University,PO Box 7062,Kampala,Uganda.
authors.forename: John K
authors.initials: JK
authors.lastname: Enyaru
authors.affiliation: 2Department of Laboratory Medicine,Radboud University Medical Center,Nijmegen,The Netherlands.
authors.forename: Harold
authors.initials: H
authors.lastname: Tjalsma
authors.affiliation: 2Department of Laboratory Medicine,Radboud University Medical Center,Nijmegen,The Netherlands.
authors.forename: Dorine W
authors.initials: DW
authors.lastname: Swinkels
authors.affiliation: 3Kuwait Institute for Scientific Research,Food and Nutrition Program,Environment and Life Sciences Research Center,Kuwait.
authors.forename: Lena
authors.initials: L
authors.lastname: Davidsson
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D016015:Logistic Models; D008288:Malaria / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D009961:Orosomucoid / Q000378:metabolism; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D011990:Receptors, Transferrin / Q000097:blood; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D064451:Hepcidins; D009961:Orosomucoid; D011990:Receptors, Transferrin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron
keywords: Uganda