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Table 3 Mediation of the association between iron deficiency (ferritin <15 μg/L) at enrolment and the birth outcomes birthweight and SGA for pregnant women in the SPCQ treatment group. 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

 

Mediator

    
 

Peripheral malaria at enrolment

Haemoglobin at enrolment

Peripheral malaria at delivery

Placental malaria at delivery

Haemoglobin at delivery

Outcome—birthweight (grammes)

Mean difference (95% CI); n = 901

Mean difference (95% CI); n = 901

Mean difference (95% CI); n = 893

Mean difference (95% CI); n = 747

Mean difference (95% CI); n = 815

 Total effect

79.0 (1.0, 157.1)

78.6 (7.5, 149.7)

68.3 (−5.5, 142.1)

46.8 (−35.6, 129.2)

58.7 (−15.5, 132.9)

 Natural direct effect

88.9 (17.2, 160.8)

78.9 (7.8, 150.0)

67.6 (−2.9, 138.0)

40.7 (−39.1, 120.6)

57.2 (−17.3, 131.7)

 Indirect effect

−9.9 (−21.5, 1.6)

−0.3 (−2.0, 1.5)

0.7 (−1.7, 3.1)

6.1 (−3.3, 15.4)

1.5 (−5.8, 8.8)

Outcome—small for gestational agea

OR (95% CI); n = 589

OR (95% CI); n = 589

OR (95% CI); n = 583

OR (95% CI); n = 486

OR (95% CI); n = 538

 Total effect

0.64 (0.41, 1.00)

0.65 (0.42, 0.99)

0.65 (0.42, 1.00)

0.71 (0.43, 1.17)

0.56 (0.36, 0.89)

 Natural direct effect

0.62 (0.40, 0.95)

0.65 (0.42, 0.99)

0.66 (0.43, 1.02)

0.71 (0.44, 1.15)

0.59 (0.37, 0.93)

 Indirect effect

1.04 (0.93, 1.16)

1.00 (0.99, 1.01)

0.98 (0.90, 1.06)

1.00 (0.86, 1.17)

0.96 (0.89, 1.03)

  1. Note. Analyses adjusted for the confounders: gravidity, season, 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). 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; SPCQ, sulphadoxine-pyrimethamine plus chloroquine
  3. aDefined as birthweight <10th centile of the Intergrowth-21 reference [36]