{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T19:54:49Z","timestamp":1790452489259,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["MR\/P022030\/1"],"award-info":[{"award-number":["MR\/P022030\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["MR\/W029294\/1"],"award-info":[{"award-number":["MR\/W029294\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Low hemoglobin is widely used as an indicator of iron deficiency anemia in India and other low\u2010and\u2010middle income counties, but anemia need not accurately reflect iron deficiency. We examined the relationship between hemoglobin and biomarkers of iron status in antenatal and postnatal period. Secondary analysis of uncomplicated singleton pregnancies in two Indian study cohorts: 1132 antenatal women in third trimester and 837 postnatal women 12\u201372\u2009h after childbirth. Associations of hemoglobin with ferritin in both data sets, and with sTfR, TSAT, and hepcidin in the postnatal cohort were examined using multivariable linear regression. Multinomial logistic regression was used to examine the association between severity of anemia and iron status. Regression models were adjusted for potential confounders. Over 55% of the women were anemic; 34% of antenatal and 40% of postnatal women had low ferritin, but 4% antenatal and 6% postnatal women had high ferritin. No evidence of association between hemoglobin and ferritin was observed (antenatal: adjusted coefficient [aCoef] \u22120.0004, 95% confidence interval [CI] \u22120.001, 0.001; postnatal: aCoef \u22120.0001, 95% CI \u22120.001, 0.001). We found a significant linear association of hemoglobin with sTfR (aCoef \u22120.04, 95% CI \u22120.07, \u22120.01), TSAT (aCoef \u22120.005, 95% CI \u22120.008, \u22120.002), and hepcidin (aCoef 0.02, 95% CI 0.02, 0.03) in postnatal women. Likelihood of low ferritin was more common in anemic than non\u2010anemic women, but high ferritin was also more common in women with severe anemia in both cohorts. Causes of anemia in pregnant and postpartum women in India are multifactorial; low hemoglobin alone is not be a useful marker of iron deficiency.<\/jats:p>","DOI":"10.1002\/ajh.27059","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T20:00:41Z","timestamp":1693512041000},"page":"1721-1731","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The complex relationship between iron status and anemia in pregnant and postpartum women in India: Analysis of two Indian study cohorts of uncomplicated pregnancies"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-5054","authenticated-orcid":false,"given":"Manisha","family":"Nair","sequence":"first","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saswati S.","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Gauhati Medical College and Hospital  Guwahati India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Rani","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences Banaras Hindu University, Banaras Hindu University Campus  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"V.","given":"Carolin","family":"Solomi","sequence":"additional","affiliation":[{"name":"Makunda Christian Leprosy and General Hospital  Karimganj India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swapna D.","family":"Kakoty","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Fakhruddin Ali Ahmed Medical College and Hospital  Barpeta India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Medhi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Fakhruddin Ali Ahmed Medical College and Hospital  Barpeta India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sereesha","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Silchar Medical College and Hospital  Silchar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranabika","family":"Mahanta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Jorhat Medical College and Hospital  Jorhat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzana","family":"Zahir","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Assam Medical College  Dibrugarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indrani","family":"Roy","sequence":"additional","affiliation":[{"name":"Nazareth Hospital  Shillong India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakuntala","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mahatma Gandhi Institute of Medical Sciences  Sevagram India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitanjali","family":"Deka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Tezpur Medical College  Tezpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bina","family":"Minz","sequence":"additional","affiliation":[{"name":"Sewa Bhawan Hospital Society  Basna India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupanjali","family":"Deka","sequence":"additional","affiliation":[{"name":"MaatHRI Srimanta Sankaradeva University of Health Sciences  Guwahati India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Opondo","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Churchill","sequence":"additional","affiliation":[{"name":"The Royal Wolverhampton Hospitals NHS Trust University of Wolverhampton  Wolverhampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7797-1567","authenticated-orcid":false,"given":"Samira","family":"Lakhal\u2010Littleton","sequence":"additional","affiliation":[{"name":"Department of Physiology, Anatomy &amp; Genetics University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-2397","authenticated-orcid":false,"given":"Elizabeta","family":"Nemeth","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine &amp; the UCLA Center for Iron Disorders University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the MaatHRI collaboration","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00084-5"},{"key":"e_1_2_11_3_1","volume-title":"Global Nutrition Targets 2025: Anaemia Policy Brief (WHO\/NMH\/NHD\/14.4)","author":"WHO","year":"2014"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32594-0"},{"key":"e_1_2_11_5_1","volume-title":"WHO Guideline on Use of Ferritin Concentrations to Assess Iron Status in Individuals and Populations","author":"WHO","year":"2020"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0281015"},{"key":"e_1_2_11_7_1","unstructured":"MissionNH.Anemia Mukt Bharat: Poshan Abhiyaan PM's Overarching Scheme for Holistic Nourishment. 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