Haemoglobin Level of Pregnant Women was Associated with History of Anemia During Adolescent Period: Findings from the Indonesia Family Life Survey

Introduction: Low hemoglobin levels in pregnant women are global health problem that adversely affect the mother’s and newborn’s health. There is no study proving the effect of anemia during adolescence in pregnancy, especially in Indonesian population. This study aimed to investigate the effect of anemia in adolescence on the hemoglobin level during pregnancy, using Indonesian Family Life Survey (IFLS) data. Methods: This retrospective cohort study used the 1997, 2007 and 2014 IFLS data. The hemoglobin levels in adolescents aged 10-18 years were obtained from the IFLS-II data in 1997. Then, the hemoglobin levels during pregnancy from the same individuals were tracked from the IFLS-IV in 2007 and IFLS-V in 2014. Data from 210 subjects were included in the analysis as these subjects had the complete data on hemoglobin levels during adolescence and pregnancy and all other considered confounding variables, such as maternal age, iron protein, vitamin C consumption, education, working status, residence, socioeconomic status, gestational age at data collection, parity, antenatal care, iron supplement consumption. Data was analyzed by T tests, Pearson’s correlation tests and General Linear Model. Results: The mean hemoglobin levels of pregnant women was 11.23 g/dL with standard deviation 1.271 and the prevalence of anemia during adolescence was 34.3%. There was a significant difference of 0.447 g/dL in the average hemoglobin levels in pregnant women with and without history of anemia during adolescence (p=0.023). The hemoglobin levels in pregnant women also differed among trimesters of gestational age (p=0.001). After being controlled for vitamin C and protein consumption, anemia status during adolescence still has a significant effect on lowering hemoglobin level during pregnancy. Conclusion: Anemia during adolescence negatively impacts pregnant women's hemoglobin levels. Prevention programs for anemia in pregnant women should be started from adolescence period.