Current Developments in Nutrition (Jun 2025)
Hemoglobin Concentrations and Prevalence of Anemia During Pregnancy: Results from the Brazilian Maternal and Child Nutrition Consortium
- Nathalia Cristina de Freitas-Costa,
- Thais Rangel Bousquet Carrilho,
- Paula Normando da Costa,
- Helena M Constante,
- Elizabeth Fujimori,
- Ana Paula Sayuri Sato,
- Gilberto Kac,
- Adauto Emmerich Oliveira,
- Alane Cabral Menezes de Oliveira,
- Ana Paula Esteves Pereira,
- Ana Paula Sayuri Sato,
- Antônio Augusto Moura da Silva,
- Carolina Abreu de Carvalho,
- Caroline de Barros Gomes,
- Claudia Leite de Moraes,
- Claudia Saunders,
- Cristina Garcia de Lima Parada,
- Daniela Saes Sartorelli,
- Dayana Rodrigues Farias,
- Denise Cavalcante de Barros,
- Denise Petrucci Gigante,
- Djanilson Barbosa dos Santos,
- Edson Theodoro dos Santos Neto,
- Elisa Maria de Aquino Lacerda,
- Elizabeth Fujimori,
- Fernanda Garanhani de Castro Surita,
- Flávia Farias Lima,
- Gilberto Kac,
- Helena Mendes Constante,
- Iracema de Mattos Paranhos Calderon,
- Isabel Oliveira Bierhals,
- Isaac Suzart Gomes-Filho,
- Jane de Carlos Santana Capelli,
- Jerusa da Mota Santana,
- José Guilherme Cecatti,
- Juliana dos Santos Vaz,
- Juraci Almeida Cesar,
- Katrini Guidolini Martinelli,
- Lívia Castro Crivellenti,
- Luana Patrícia Marmitt,
- Marco Fabio Mastroeni,
- Maria Angélica A Nunes,
- Maria Antonieta de Barros Leite Carvalhaes,
- Maria do Carmo Leal,
- Maria Inês Schmidt,
- Maria Fernanda Larcher de Almeida,
- Mayra Pacheco Fernandes,
- Michael Eduardo Reichenheim,
- Michele Drehmer,
- Mônica Araujo Batalha,
- Nathalia Cristina de Freitas-Costa,
- Patricia de Carvalho Padilha,
- Renato Passini Junior,
- Renato Teixeira Souza,
- Silmara Salete de Barros Silva Mastroeni,
- Silvia Regina Dias Medici Saldiva,
- Sílvio O M Prietsch,
- Simone Seixas da Cruz,
- Sirlei Siani Morais,
- Sotero Serrate Mengue,
- Thaís Rangel Bousquet Carrilho,
- Vera Lúcia Bosa
Affiliations
- Nathalia Cristina de Freitas-Costa
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Thais Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Obstetrics and Gynaecology, University of British Columbia, Faculty of Medicine, Vancouver, Canada
- Paula Normando da Costa
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Helena M Constante
- Department of Sociological Studies, University of Sheffield, Sheffield, United Kingdom
- Elizabeth Fujimori
- Department of Public Health Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil
- Ana Paula Sayuri Sato
- Department of Epidemiology, University of São Paulo, São Paulo, Brazil
- Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Corresponding author.
- Adauto Emmerich Oliveira
- Postgraduate Program in Collective Health, Federal University of Espírito Santo
- Alane Cabral Menezes de Oliveira
- Postgraduate Program in Nutrition, Faculty of Nutrition, Federal University of Alagoas and Postgraduate Program of Health Science, Institute of Biological Sciences and Health, Federal University of Alagoas
- Ana Paula Esteves Pereira
- National School of Public Health, Oswaldo Cruz Foundation
- Ana Paula Sayuri Sato
- Department of Epidemiology, School of Public Health, University of São Paulo
- Antônio Augusto Moura da Silva
- Postgraduate Program in Public Health, Federal University of Maranhão
- Carolina Abreu de Carvalho
- Postgraduate Program in Public Health, Federal University of Maranhão
- Caroline de Barros Gomes
- Postgraduate Program in Public Health, Botucatu Medical School, São Paulo State University
- Claudia Leite de Moraes
- Department of Epidemiology, Institute of Social Medicine Hesio Cordeiro, Rio de Janeiro State University; Graduate Program in Family Health , Estácio de Sá University
- Claudia Saunders
- Department of Nutrition and Dietetics, Josue de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Cristina Garcia de Lima Parada
- Botucatu Medical School, São Paulo State University
- Daniela Saes Sartorelli
- Postgraduate Program in Public Health; Postgraduate Program in Nutrition and Metabolism, Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo
- Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josue de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Denise Cavalcante de Barros
- National School of Public Health, Oswaldo Cruz Foundation
- Denise Petrucci Gigante
- Department of Nutrition, Faculty of Nutrition, Federal University of Pelotas
- Djanilson Barbosa dos Santos
- Health Sciences Center, Federal University of Recôncavo da Bahia
- Edson Theodoro dos Santos Neto
- Postgraduate Program in Collective Health, Federal University of Espírito Santo
- Elisa Maria de Aquino Lacerda
- Department of Nutrition and Dietetics, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Elizabeth Fujimori
- Public Health Nursing Department, School of Nursing, University of São Paulo
- Fernanda Garanhani de Castro Surita
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas
- Flávia Farias Lima
- Federal University of Rio de Janeiro, campus Macaé
- Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josue de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Helena Mendes Constante
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josue de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Iracema de Mattos Paranhos Calderon
- Department of Gynecology and Obstetrics, Botucatu School of Medicine, Paulista State University Júlio de Mesquita Filho
- Isabel Oliveira Bierhals
- Public Health Graduate Program, University of Southern Santa Catarina. Criciúma, Santa Catarina, Brazil
- Isaac Suzart Gomes-Filho
- Department of Health, Feira de Santana State University
- Jane de Carlos Santana Capelli
- Federal University of Rio de Janeiro, campus Macaé
- Jerusa da Mota Santana
- Health Sciences Center, Federal University of Recôncavo da Bahia
- José Guilherme Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas
- Juliana dos Santos Vaz
- Postgraduate Program in Nutrition and Foods, Faculty of Nutrition, Federal University of Pelotas
- Juraci Almeida Cesar
- Postgraduate Program in Public Health, Federal University of Rio Grande
- Katrini Guidolini Martinelli
- Postgraduate Program in Collective Health, Federal University of Espírito Santo
- Lívia Castro Crivellenti
- Postgraduate Program in Public Health, Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo
- Luana Patrícia Marmitt
- Postgraduate Program in Bioscience and Health, University of Western Santa Catarina
- Marco Fabio Mastroeni
- Postgraduate Program in Health and Environment, University of Joinville Region
- Maria Angélica A Nunes
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul
- Maria Antonieta de Barros Leite Carvalhaes
- Botucatu Medical School, São Paulo State University
- Maria do Carmo Leal
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Oswaldo Cruz Foundation
- Maria Inês Schmidt
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul
- Maria Fernanda Larcher de Almeida
- Federal University of Rio de Janeiro, campus Macaé
- Mayra Pacheco Fernandes
- Postgraduate program in Epidemiology, Department of Social Medicine, Federal University of Pelotas
- Michael Eduardo Reichenheim
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University
- Michele Drehmer
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul
- Mônica Araujo Batalha
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josue de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Nathalia Cristina de Freitas-Costa
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josue de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Patricia de Carvalho Padilha
- Department of Nutrition and Dietetics, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Renato Passini Junior
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas
- Renato Teixeira Souza
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas
- Silmara Salete de Barros Silva Mastroeni
- Health Sciences Center, University of the Joinville Region
- Silvia Regina Dias Medici Saldiva
- Hospital of Clinics, Faculty of Medicine, University of São Paulo
- Sílvio O M Prietsch
- Postgraduate Program in Public Health, Federal University of Rio Grande
- Simone Seixas da Cruz
- Department of Epidemiology, Federal University of Recôncavo da Bahia
- Sirlei Siani Morais
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas
- Sotero Serrate Mengue
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul
- Thaís Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josue de Castro Nutrition Institute, Federal University of Rio de Janeiro
- Vera Lúcia Bosa
- Postgraduate Program in Food, Nutrition and Health, Department of Nutrition, Federal University of Rio Grande do Sul
- Journal volume & issue
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Vol. 9,
no. 6
p. 107458
Abstract
Background: Anemia is common among pregnant women from low- and middle-income countries, but national estimates are scarce. Objectives: We aimed to assess hemoglobin (Hb) concentrations and the anemia prevalence in Brazil. Methods: Data included 12,287 pregnant women aged 15–49 y and 17,967 measurements from 7 studies (2007–2014) participating in the Brazilian Maternal and Child Nutrition Consortium. Hb (g/dL) was obtained from medical records (6 studies, 17,565 measurements) or capillary blood samples (1 study, 402 measurements). Hb <11, <10.5, and <11 g/dL were used to define anemia at the first, second, and third trimesters using the 2024 WHO guideline. Identification of implausible Hb values and heterogeneity analysis were performed. We estimated medians and interquartile ranges for the Hb concentration and prevalence and 95% confidence intervals (CI) of anemia according to maternal prepregnancy BMI, age, and education, gestational trimester, and year of data collection. Results: Median Hb was 12.0 (95% CI: 11.2, 12.8) g/dL; no differences were observed according to the studied covariables. Anemia prevalence was 14.1% (95% CI: 13.6, 14.6), and highest during 2013 [27.9% (95% CI: 17.3%, 38.6%)] and in the third trimester [23.5% (95% CI: 22.5%, 24.6%)]. Higher anemia prevalence in the third compared with the first trimester was also observed among women aged 15–19 [1st: 8.02% (95% CI: 6.2%, 9.9%); 3rd: 28.1% (95% CI: 25.4%, 30.8%)] than those aged 20–49 y [1st: 6.5%; (5.8%, 7.2%); 3rd: 22.6% (95% CI: 21.4%, 23.7%)]. Anemia prevalence for those with education ≤4 y (15.9%; 95% CI: 14.1%, 17.8%) and women with prepregnancy underweight (19.2%; 95% CI: 15.9%, 22.4%) and normal weight (15.3%; 95% CI: 14.4%, 16.2%) were higher than those with 9–11 (13.1%; 95% CI: 12.4%, 13.8%) and 12–18 y (10.3%; 95% CI: 9.2%, 11.0%), and overweight (12.2%; 95% CI: 10.8%, 13.6%) and obesity (9.9%; 95% CI: 8.1%, 11.7%). Conclusions: Anemia was higher in adolescents compared with older women and in the third trimester compared with the first, underscoring the need for targeted monitoring during these periods.
