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Table 2 Associations of maternal ferritin at first antenatal visit with birthweight, low birthweight (n = 1840), small-for-gestational age, and preterm birth (n = 1208), overall and stratified by malaria prevention regimen. Madang Province, Papua New Guinea, 2009–2013

From: The relationship between markers of antenatal iron stores and birth outcomes differs by malaria prevention regimen—a prospective cohort study

 

Overall

Malaria prevention regimen

 
 

Adjusted mean difference (95% CI); P

SPCQ (n = 898)

Adjusted mean difference (95% CI); P

SPAZ (n = 934)

Adjusted mean difference (95% CI); P

P interaction parameter

Birthweight (grammes)

Iron stores (measured by ferritin) (log2) μg/L

−11 (−27, 6); 0.19

−26 (−50, −1); 0.041

9 (−13, 31); 0.45

0.041

Iron deficiency

    

  Ferritin <15 μg/L

46 (−0.4, 92); 0.052

81 (10, 152); 0.025

6 (−54; 66); 0.845

0.11

  Ferritin ≥15 μg/L

Reference

Reference

Reference

 
 

Adjusted OR (95% CI); P

Adjusted OR (95% CI); P

Adjusted OR (95% CI); P

 

Low birthweight (<2500 g)

Iron stores (measured by ferritin) (log2) μg/L

1.00 (0.90, 1.11); 0.99

1.15 (1.00, 1.32); 0.050

0.80 (0.67, 0.94); 0.009

0.001

Iron deficiency

    

  Ferritin <15 μg/L

0.86 (0.64, 1.15); 0.31

0.73 (0.49, 1.08); 0.12

1.10 (0.70, 1.73); 0.69

0.18

  Ferritin ≥15 μg/L

Reference

Reference

Reference

 

Preterm birth (<37 weeks)

 

SPCQ (n = 586)

SPAZ (n = 622)

 

Iron stores (measured by ferritin) (log2) μg/L

1.03 (0.87, 1.20); 0.77

1.03 (0.84, 1.27); 0.79

0.98 (0.75, 1.28); 0.87

0.91

Iron deficiency

    

  Ferritin <15 μg/L

0.85 (0.54, 1.34); 0.48

0.94 (0.51, 1.73); 0.84

0.82 (0.40, 1.65); 0.57

0.62

  Ferritin ≥15 μg/L

Reference

Reference

Reference

 

Small-for-gestational-agea

Iron stores (measured by ferritin) (log2) μg/L

1.11 (0.99, 1.24); 0.066

1.25 (1.06, 1.46); 0.007

0.98 (0.84, 1.15); 0.80

0.02

Iron deficiency

    

  Ferritin <15 μg/L

0.79 (0.59, 1.07); 0.12

0.67 (0.44, 1.04); 0.072

0.91 (0.60, 1.40); 0.77

0.19

  Ferritin ≥15 μg/L

Reference

Reference

Reference

 
  1. Note. Linear regression analyses were performed for the outcome birthweight, with mean difference (95% CI) presented and logistic regression for the outcomes, low birthweight, preterm birth, and small-for-gestational age, with odds ratios (95% CI) presented. Analyses were adjusted for gravidity, season, number of antenatal visits, clinic location, mid-upper arm circumference (< 23cm, ≥ 23 cm), stunting (height <150 cm, ≥ 150 cm), ethnicity, bed net use, smoking, betel nut use, and gestational age at enrolment, i.e. at ferritin measurement (as estimated by fundal height). Models also included the covariates sex of the newborn, timing of birthweight measurement (analyses including birthweight only), and treatment arm (overall analysis only). Ferritin levels were adjusted for concomitant inflammation using the BRINDA (Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia) approach [16]
  2. Abbreviations: CI, confidence interval; OR, odds ratio; SPAZ, sulphadoxine-pyrimethamine plus azithromycin; SPCQ, SP plus chloroquine
  3. aDefined as birthweight <10th centile of the Intergrowth-21 reference [36]