Weight, height, and midupper arm circumference are associated with haemoglobin levels in adolescent girls living in rural India: A cross-sectional study.

Anand S Ahankari,Laila J Tata,Andrew W Fogarty

doi:10.1111/mcn.12908

Anand S Ahankari, Laila J Tata + Show 1 more

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https://doi.org/10.1111/mcn.12908

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Abstract

We aimed to explore the association of physical parameters with haemoglobin (Hb) levels to test the hypothesis that impaired physical development is associated with anaemia. A cross‐sectional survey study recruited adolescent girls (13 to 17 years) living in rural areas of Maharashtra state of India. Data were collected on physical parameters include height, weight, and midupper arm circumference (MUAC). Hb levels were measured using Sahli's haemometer. Linear regression was conducted to test the hypothesis. Data were collected from 1,010 girls on physical parameter and Hb levels. The majority of the adolescent girls were diagnosed with anaemia (87%). The regression analysis adjusted for age gave a significant association of Hb levels with all three variables (MUAC, weight, and height). Hb increased by 0.11 g/dl with an each centimetre of increase in MUAC (95% confidence interval, CI, [0.08, 0.15], P < .001). Each kilogram of increase in the body weight showed an increase in Hb levels (0.02 g dl, 95% CI [0.01, 0.03], P = .001). With an each centimetre of increase in height, Hb increased by 0.01 g dl (95% CI [0.00, 0.02], P = .022). There was a consistent association between three measures of somatic growth and anaemia in the study population. It is likely that life‐course exposures from conception onwards contribute to this, and the public health implications are that preventing anaemia is a challenge that requires a multifaceted interventional approach. Understanding the importance of the timing of these life exposures will help design interventions that can achieve optimal results.

Highlights

Anaemia is a global public health burden that affects half of preschool children, adolescent girls, and pregnant women
Data were collected from 1,010 adolescent girls from 1,023 who were invited to participate, giving a response rate of 99%
The majority of the adolescent girls were diagnosed with anaemia (87%), and of these, 17% had mild anaemia (Hb: 11.0 to 11.9 g dl), 65% had moderate anaemia (Hb: 8.0 to 10.9 g dl), and 5% had severe anaemia (Hb: ≤7.9 g dl)

Summary

Introduction

Anaemia is a global public health burden that affects half of preschool children, adolescent girls, and pregnant women. Organisation (WHO) has recognised anaemia as the second‐leading cause of disability and estimated that the number of anaemic cases worldwide is close to two billion (WHO, 2019a). India has the highest anaemic population that affects primarily pregnant women and Matern Child Nutr. Out of 110 million Indian adolescent girls, between 68 and 98 million are estimated to be anaemic (WHO, 2019b). The cost of anaemia is estimated to be 6% of India's Gross Domestic Product (Sedlander, Rimal, Talegawkar, Yilma, & Munar, 2018; approximate annual loss of 135 billion USD). A recent study from the north‐east region of India reported 54% of stunting in adolescents, which was higher in girls compared with boys (Pal, Pari, Sinha, & Dhara, 2017)

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