Evidence map›Paper›PMID 30629202›Full record

ArticleThe Journal of nutrition2019

Prenatal Iron Deficiency and Replete Iron Status Are Associated with Adverse Birth Outcomes, but Associations Differ in Ghana and Malawi.

Brietta M Oaks, Josh M Jorgensen, Lacey M Baldiviez, Seth Adu-Afarwuah, Ken Maleta, Harriet Okronipa, John Sadalaki, Anna Lartey, Per Ashorn, Ulla Ashorn and 3 more

2 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of nutrition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 22 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 6 pooled it
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00970866 nacompletednot on this map

Efficacy of Lipid-based Nutrient Supplements (LNS) for Pregnant and Lactating Women and Their Infants

TypeinterventionalSponsorUniversity of California, DavisRan2009 to 2017Enrolled3,499ConditionsAnemia, Malnutrition, StuntingArmsIron and Folic Acid (IFA), Multiple Micronutrient (MMN) group, Lipid-based Nutrient Supplements (LNS) group
NCT01239693 phase3active not recruitingnot on this map

A Research Plan for a Randomised, Single-blind, Parallel Group Controlled Trial in Rural Malawi, Testing the Health Effects of Supplementing Maternal Diet During Pregnancy and Lactation and Infant Diet From 6 to 18 Months of Age With High-energy, Micronutrient Fortified Lipid-based Nutrient Supplements (LNS)

TypeinterventionalSponsorTampere UniversityRan2011 to 2027Enrolled1,391ConditionsInfant Malnutrition, Malnutrition in PregnancyArmsIFA, MMN, LNS
3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 6 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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  8. Iron deficiency with and without anemia in pregnancy: A scoping review of prevalence and perinatal impact.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 4 countries.

Brietta M OaksDepartment of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI.
Josh M JorgensenProgram in International and Community Nutrition, Department of Nutrition.
Lacey M BaldiviezUSDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA.
Seth Adu-AfarwuahDepartment of Nutrition and Food Science, University of Ghana, Legon, Ghana.
Ken MaletaDepartment of Community Health, University of Malawi College of Medicine, Blantyre, Malawi.
Harriet OkronipaProgram in International and Community Nutrition, Department of Nutrition.
John SadalakiDepartment of Community Health, University of Malawi College of Medicine, Blantyre, Malawi.
Anna LarteyDepartment of Nutrition and Food Science, University of Ghana, Legon, Ghana.
Per AshornDepartment of Paediatrics, Tampere University Hospital, Tampere, Finland.
Ulla AshornDepartment of Paediatrics, Tampere University Hospital, Tampere, Finland.
Stephen VostiDepartment of Agricultural and Resource Economics, University of California, Davis, CA.
Lindsay H AllenUSDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA.
Kathryn G DeweyProgram in International and Community Nutrition, Department of Nutrition.
University of Ghana · GHAgricultural Research Service · USTampere University Hospital · FIUniversity of Malawi · MWUniversity of California, Davis · USUniversity of Rhode Island · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious literature suggests a U-shaped relation between hemoglobin concentration and adverse birth outcomes. There is less evidence on associations between iron status and birth outcomes.

objectiveOur objective was to determine the associations of maternal hemoglobin concentration and iron status with birth outcomes.

methodsWe conducted a secondary data analysis of data from 2 cohorts of pregnant women receiving iron-containing nutritional supplements (20-60 mg ferrous sulfate) in Ghana (n = 1137) and Malawi (n = 1243). Hemoglobin concentration and 2 markers of iron status [zinc protoporphyrin and soluble transferrin receptor (sTfR)] were measured at ≤20 weeks and 36 weeks of gestation. We used linear and Poisson regression models and birth outcomes included preterm birth (PTB), newborn stunting, low birth weight (LBW), and small-for-gestational-age.

resultsPrevalence of iron deficiency (sTfR >6.0 mg/L) at enrollment was 9% in Ghana and 20% in Malawi. In early pregnancy, iron deficiency was associated with PTB (9% compared with 17%, adjusted RR: 1.63; 95% CI: 1.14, 2.33) and stunting (15% compared with 23%, adjusted RR: 1.44; 95% CI: 1.09, 1.94) in Malawi but not Ghana, and was not associated with LBW in either country; replete iron status (sTfR <10th percentile) was associated with stunting (9% compared with 15%, adjusted RR: 1.71; 95% CI: 1.06, 2.77) in Ghana, but not PTB or LBW, and was not associated with any birth outcomes in Malawi. In late pregnancy, iron deficiency was not related to birth outcomes in either country and iron-replete status was associated with higher risk of LBW (8% compared with 16%, adjusted RR: 1.90; 95% CI: 1.17, 3.09) and stunting (6% compared with 13%, adjusted RR: 2.14; 95% CI: 1.21, 3.77) in Ghana, but was not associated with birth outcomes in Malawi.

conclusionsThe associations of low or replete iron status with birth outcomes are population specific. Research to replicate and extend these findings would be beneficial. These trials were registered at clinicaltrials.gov as NCT00970866 (Ghana) and NCT01239693 (Malawi).

Indexed as

Iron DeficienciesPregnancy OutcomeAnemia, Iron-DeficiencyFemaleGhanaGrowth DisordersHumansInfant, Low Birth WeightInfant, NewbornInfant, Small for Gestational AgeMalawiNutrition DisordersPregnancyPremature BirthPrenatal Nutritional Physiological PhenomenaanemiaGhanairon deficiencyiron statuslow birth weightMalawinewborn stuntingpregnancypreterm birth

Identifiers

PMID30629202
PMCPMC6398386
OpenAlexW2910727558

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.