Original Research

Anaemia at mid-pregnancy is associated with prehypertension in late pregnancy among urban women

Caylin Goodchild, Elizabeth A. Symington, Jeannine Baumgartner, Lizelle Zandberg, Amy J. Wise, Cornelius M. Smuts, Linda Malan
Health SA Gesondheid | Vol 29 | a2610 | DOI: https://doi.org/10.4102/hsag.v29i0.2610 | © 2024 Caylin Goodchild, Elizabeth Anna Symington, Jeannine Baumgartner, Lizelle Zandberg, Amy Juliet Wise, Cornelius Marius Smuts, Linda Malan | This work is licensed under CC Attribution 4.0
Submitted: 22 January 2024 | Published: 29 June 2024

About the author(s)

Caylin Goodchild, Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
Elizabeth A. Symington, Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, University of South Africa, Johannesburg, South Africa
Jeannine Baumgartner, Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa; and Department of Nutritional Sciences, King’s College London, London, United Kingdom
Lizelle Zandberg, Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
Amy J. Wise, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; and Empilweni Services and Research Unit, University of the Witwatersrand, Johannesburg, South Africa
Cornelius M. Smuts, Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
Linda Malan, Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa

Abstract

Background: Antenatal iron deficiency and anaemia are associated with gestational hypertension and diabetes mellitus, but so are elevated iron stores and haemoglobin. In South Africa, pregnant women receive routine iron supplementation regardless of iron status.

Aim: This study aimed to assess associations of antenatal iron status and anaemia with blood pressure in pregnant women in urban South Africa. Secondary to this, associations with heart rate, fasting glucose and glucose tolerance were also investigated.

Setting: Johannesburg, South Africa.

Methods: A total of 250 pregnant women, aged 27 (24–32) years, were recruited using consecutive sampling. The authors measured biomarkers of iron status and anaemia at < 18 and ± 22 weeks’, blood pressure and heart rate at ± 36 weeks’, and fasting glucose and glucose tolerance between 24 and 28 weeks’ gestation. Associations were determined using multivariable regression models adjusted for confounders.

Results: The odds of prehypertension in late pregnancy among women with anaemia at ± 22 weeks’ gestation were three times higher than among women without anaemia (odds ratio [OR]: 3.01, 95% confidence interval [CI]: 1.22, 7.42). Participants with anaemia at ± 22 weeks’ gestation had 2.15 times higher odds of having elevated mean arterial pressure than women without anaemia (OR: 2.15, 95% CI: 1.01, 4.60).

Conclusion: Anaemia at mid-pregnancy could be a predictor of hypertensive disorders in pregnancy. The cause of antenatal anaemia may need further investigation apart from iron deficiency. The effective management of anaemia in pregnant women living in urban South Africa remains a challenge.

Contribution: This study provides evidence about the health impact of pregnant women regarding antenatal supplementation practices in South Africa.


Keywords

anaemia; prehypertension; blood pressure; fasting glucose; gestation; glucose tolerance; iron supplementation; pregnancy

Sustainable Development Goal

Goal 3: Good health and well-being

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