Evidence map›Paper›PMID 40632804›Full record

ArticlePLOS global public health2025

Iron deficiency anaemia in mothers and infants with high inflammatory burden: Prevalence and profile in a South African birth cohort.

Jessica E Ringshaw, Michal R Zieff, Sadeeka Williams, Chloë A Jacobs, Zayaan Goolam Nabi, Thandeka Mazubane, Marlie Miles, Donna Herr, Daniel C Alexander, Melissa Gladstone and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Cortisol Stress Response is Associated with Iron Status in Pregnancy.medRxiv : the preprint server for health sciences · 2026
    Article
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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

19 authors.

Jessica E RingshawDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-6885-8351
Michal R ZieffDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-9352-9947
Sadeeka WilliamsDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Chloë A JacobsDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Zayaan Goolam NabiDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Thandeka MazubaneDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Marlie MilesDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0009-0004-7526-8885
Donna HerrDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Daniel C AlexanderHawkes Institute and Department of Computer Science, University College London, London, England, United Kingdom.
Melissa GladstoneDepartment of Women and Children's Health, Institute of Life Course and Medical Science, Alder Hey Children's NHS Foundation Trust, University of Liverpool, Liverpool, England, United Kingdom.
Vanja Klepac-CerajDepartment of Biological Sciences, Wellesley College, Wellesley, Massachusetts, United States of America.
Laurel J Gabard-DurnamDepartment of Psychology, Northeastern University, Boston, Massachusetts, United States of America.
Dima AmsoDepartment of Psychology, Columbia University, New York, New York, United States of America.
William P FiferDepartment of Psychiatry, Irving Medical Center, Columbia University, New York, New York, United States of America.
Derek K JonesCardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, Wales, United Kingdom.
Dan J SteinNeuroscience Institute, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-7218-7810
Steven C R WilliamsCentre for Neuroimaging Sciences, Department of Neuroimaging, Kings College London, London, England, United Kingdom.
Kirsten A DonaldDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Khula South Africa Study Team

Funding

Bill & Melinda Gates Foundation INV-023509Wellcome Trust
6 · The paper itself

Abstract

The scarcity of epidemiological data on anaemia in low- and middle-income countries, coupled with contrasting approaches to the assessment of iron status with inflammation, represent critical research gaps. This study characterised the prevalence and profile of iron deficiency anaemia, including adjustment for inflammation, in mothers and infants from South Africa. Mother-child dyads (n = 394) were recruited (2021-2022) for the Khula birth cohort in Cape Town. Haematological metrics, iron metrics, and inflammatory biomarkers were obtained from mothers antenatally and 3-6 months postnatally, and infants 3-18 months postnatally. The extent to which inflammation impacted iron deficiency was assessed using two methods; Method A: higher serum ferritin thresholds for classifying iron status in participants with inflammation (World Health Organisation), Method B: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anaemia (BRINDA) regression which corrects serum ferritin based on inflammatory biomarker concentrations. Prevalence of maternal anaemia was 34.74% (107/308) in pregnancy and 22.50% (54/240) in mothers at 3-6 months after childbirth. Of their infants, 46.82% (125/267) and 48.10% (136/283) were anaemic by 6-12 months and 12-18 months, respectively. Using Method A, the prevalence of maternal iron deficiency (regardless of anaemia), increased from 18.35% (20/109) to 55.04% (60/109) in pregnancy, and from 11.97% (28/234) to 46.58% (109/234) postnatally. Similarly, using Method B, maternal iron deficiency prevalence increased to 38.53% (42/109) in pregnancy, and 25.21% (59/234) postnatally. In infants at 12-18 months, the prevalence of iron deficiency increased from 19.79% (19/96) to 31.25% (30/96) and 32.29% (31/96) using Methods A and B, respectively. Approximately half of anaemia cases in mothers antenatally (50%; 20/40) and postnatally (45.10%; 23/51), and infants at 12-18 months (55.56%; 10/18), were attributable to iron deficiency. This is one of the first studies reporting the extent to which iron deficiency anaemia may be underestimated if inflammation is unaccounted for in South African mothers and infants.

Identifiers

PMID40632804
PMCPMC12240388

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