{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:23:54Z","timestamp":1772166234470,"version":"3.50.1"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100004439","name":"William and Flora Hewlett Foundation","doi-asserted-by":"publisher","award":["2017-5795, 2020-1162"],"award-info":[{"award-number":["2017-5795, 2020-1162"]}],"id":[{"id":"10.13039\/100004439","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004439","name":"William and Flora Hewlett Foundation","doi-asserted-by":"publisher","award":["2014-9952, 2017-5795"],"award-info":[{"award-number":["2014-9952, 2017-5795"]}],"id":[{"id":"10.13039\/100004439","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Health"],"DOI":"10.1186\/s12978-026-02268-2","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T07:46:47Z","timestamp":1768895207000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hormonal contraception and hemoglobin levels in urban Malawi: a longitudinal analysis"],"prefix":"10.1186","volume":"23","author":[{"given":"Mahesh","family":"Karra","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Canning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"4, Supplement","key":"2268_CR1","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1016\/j.ajog.2011.06.056","volume":"205","author":"K Maguire","year":"2011","unstructured":"Maguire K, Westhoff C. The state of hormonal contraception today: established and emerging noncontraceptive health benefits. Am J Obstet Gynecol. 2011;205(4, Supplement):S4\u20138.","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"2268_CR2","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1080\/09513590802005562","volume":"24","author":"AE Schindler","year":"2008","unstructured":"Schindler AE. Non-contraceptive use of hormonal contraceptives. Gynecol Endocrinol. 2008;24(5):235\u20136.","journal-title":"Gynecol Endocrinol"},{"issue":"5","key":"2268_CR3","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/j.contraception.2010.05.005","volume":"82","author":"IS Fraser","year":"2010","unstructured":"Fraser IS. Non-contraceptive health benefits of intrauterine hormonal systems. Contraception. 2010;82(5):396\u2013403.","journal-title":"Contraception"},{"key":"2268_CR4","doi-asserted-by":"crossref","unstructured":"Fraser IS, Kovacs GT. The efficacy of non-contraceptive uses for hormonal contraceptives. Med J Aust. 2003;178(12):621\u20133.","DOI":"10.5694\/j.1326-5377.2003.tb05387.x"},{"key":"2268_CR5","doi-asserted-by":"crossref","unstructured":"Huber JC, Bentz EK, Ott J, Tempfer CB. Non-contraceptive benefits of oral contraceptives. Expert Opinion on Pharmacotherapy. 2008;9(13):2317\u201325.","DOI":"10.1517\/14656566.9.13.2317"},{"key":"2268_CR6","unstructured":"Jensen JT. The benefits of reduced menstrual bleeding associated with the use of contraceptive methods. In: Gynecol Forum. 15;2010."},{"issue":"2","key":"2268_CR7","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1136\/thoraxjnl-2020-215540","volume":"76","author":"BI Nwaru","year":"2021","unstructured":"Nwaru BI, Tibble H, Shah SA, Pillinger R, McLean S, Ryan DP, et al. Hormonal contraception and the risk of severe asthma exacerbation: 17-year population-based cohort study. Thorax. 2021;76(2):109\u201315.","journal-title":"Thorax"},{"key":"2268_CR8","doi-asserted-by":"crossref","unstructured":"Bahamondes L, Valeria Bahamondes M, Shulman LP. Non-contraceptive benefits of hormonal and intrauterine reversible contraceptive methods. Human Reproduction Update. 2015;21(5):640\u201351.","DOI":"10.1093\/humupd\/dmv023"},{"issue":"5","key":"2268_CR9","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1054\/bjoc.2000.1622","volume":"84","author":"E Fernandez","year":"2001","unstructured":"Fernandez E, Vecchia CL, Balducci A, Chatenoud L, Franceschi S, Negri E. Oral contraceptives and colorectal cancer risk: a meta-analysis. Br J Cancer. 2001;84(5):722\u20137.","journal-title":"Br J Cancer"},{"issue":"6","key":"2268_CR10","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1093\/humupd\/dmq022","volume":"16","author":"D Cibula","year":"2010","unstructured":"Cibula D, Gompel A, Mueck AO, La Vecchia C, Hannaford PC, Skouby SO, et al. Hormonal contraception and risk of cancer. Hum Reprod Update. 2010;16(6):631\u201350.","journal-title":"Hum Reprod Update"},{"issue":"4","key":"2268_CR11","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1016\/j.ajog.2011.06.057","volume":"205","author":"LP Shulman","year":"2011","unstructured":"Shulman LP. The state of hormonal contraception today: benefits and risks of hormonal contraceptives: combined Estrogen and progestin contraceptives. Am J Obstet Gynecol. 2011;205(4):S9\u201313.","journal-title":"Am J Obstet Gynecol"},{"issue":"23","key":"2268_CR12","doi-asserted-by":"publisher","first-page":"2228","DOI":"10.1056\/NEJMoa1700732","volume":"377","author":"LS M\u00f8rch","year":"2017","unstructured":"M\u00f8rch LS, Skovlund CW, Hannaford PC, Iversen L, Fielding S, Lidegaard \u00d8. Contemporary hormonal contraception and the risk of breast cancer. N Engl J Med. 2017;377(23):2228\u201339.","journal-title":"N Engl J Med"},{"issue":"2","key":"2268_CR13","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1067\/mob.2001.115862","volume":"185","author":"JM Baeten","year":"2001","unstructured":"Baeten JM, Nyange PM, Richardson BA, Lavreys L, Chohan B, Martin HL, et al. Hormonal contraception and risk of sexually transmitted disease acquisition: results from a prospective study. Am J Obstet Gynecol. 2001;185(2):380\u20135.","journal-title":"Am J Obstet Gynecol"},{"issue":"10021","key":"2268_CR14","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1016\/S0140-6736(15)60865-0","volume":"387","author":"A Lopez","year":"2016","unstructured":"Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016;387(10021):907\u201316.","journal-title":"Lancet"},{"key":"2268_CR15","doi-asserted-by":"crossref","unstructured":"Karami M, Chaleshgar M, Salari N, Akbari H, Mohammadi M. Global prevalence of anemia in pregnant women: A comprehensive systematic review and Meta-Analysis. Matern Child Health J 2022;26(7):1473\u201387.","DOI":"10.1007\/s10995-022-03450-1"},{"issue":"9","key":"2268_CR16","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1172\/JCI21441","volume":"113","author":"NC Andrews","year":"2004","unstructured":"Andrews NC. Anemia of inflammation: the cytokine-hepcidin link. J Clin Invest. 2004;113(9):1251\u20133.","journal-title":"J Clin Invest"},{"issue":"2","key":"2268_CR17","first-page":"1","volume":"13","author":"MA Mbule","year":"2013","unstructured":"Mbule MA, Byaruhanga YB, Kabahenda M, Lubowa A. Determinants of anaemia among pregnant women in rural Uganda. Rural Remote Health. 2013;13(2):1\u201315.","journal-title":"Rural Remote Health"},{"issue":"4","key":"2268_CR18","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1017\/S1368980008002401","volume":"12","author":"E McLean","year":"2009","unstructured":"McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information System, 1993\u20132005. Public Health Nutr. 2009;12(4):444\u201354.","journal-title":"Public Health Nutr"},{"key":"2268_CR19","doi-asserted-by":"crossref","unstructured":"Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and National trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995\u20132011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16\u201325.","DOI":"10.1016\/S2214-109X(13)70001-9"},{"issue":"1\u20132","key":"2268_CR20","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s002770050405","volume":"77","author":"N Milman","year":"1998","unstructured":"Milman N, Clausen J, Byg KE. Iron status in 268 Danish women aged 18\u201330 years: influence of menstruation, contraceptive method, and iron supplementation. Ann Hematol. 1998;77(1\u20132):13\u20139.","journal-title":"Ann Hematol"},{"key":"2268_CR21","doi-asserted-by":"crossref","unstructured":"Aboagye RG, Okyere J, Seidu AA, Ahinkorah BO, Budu E, Yaya S. Relationship between history of hormonal contraceptive use and anaemia status among women in sub-Saharan africa: A large population-based study. PLoS ONE. 2023;14(6):e0286392.","DOI":"10.1371\/journal.pone.0286392"},{"key":"2268_CR22","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.srhc.2017.07.003","volume":"13","author":"ZT Haile","year":"2017","unstructured":"Haile ZT, Kingori C, Teweldeberhan AK, Chavan B. The relationship between history of hormonal contraceptive use and iron status among women in tanzania: A population-based study. Sex Reproductive Healthc. 2017;13:97\u2013102.","journal-title":"Sex Reproductive Healthc"},{"issue":"1","key":"2268_CR23","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1136\/bmjsrh-2018-200178","volume":"45","author":"S Gebremedhin","year":"2019","unstructured":"Gebremedhin S, Asefa A. Association between type of contraceptive use and haemoglobin status among women of reproductive age in 24 sub-Saharan Africa countries. BMJ Sex Reprod Health. 2019;45(1):54\u201360.","journal-title":"BMJ Sex Reprod Health"},{"issue":"3","key":"2268_CR24","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.contraception.2017.11.001","volume":"97","author":"S Bellizzi","year":"2018","unstructured":"Bellizzi S, Ali MM. Effect of oral contraception on anemia in 12 low- and middle-income countries. Contraception. 2018;97(3):236\u201342.","journal-title":"Contraception"},{"key":"2268_CR25","doi-asserted-by":"crossref","unstructured":"Milsom I, Andersson K, Jonasson K, Lindstedt G, Rybo G. The influence of the Gyne-T 380S IUD on menstrual blood loss and iron status. Contraception. 1995;52(3):175\u20139.","DOI":"10.1016\/0010-7824(95)00163-5"},{"issue":"5","key":"2268_CR26","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1016\/S0002-9378(99)70120-1","volume":"181","author":"R Rivera","year":"1999","unstructured":"Rivera R, Yacobson I, Grimes D. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices. Am J Obstet Gynecol. 1999;181(5):1263\u20139.","journal-title":"Am J Obstet Gynecol"},{"key":"2268_CR27","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1016\/j.jconrel.2020.12.044","volume":"330","author":"S Sivasankaran","year":"2021","unstructured":"Sivasankaran S, Jonnalagadda S. Advances in controlled release hormonal technologies for contraception: A review of existing devices, underlying mechanisms, and future directions. J Controlled Release. 2021;330:797\u2013811.","journal-title":"J Controlled Release"},{"issue":"4","key":"2268_CR28","doi-asserted-by":"publisher","first-page":"160","DOI":"10.4314\/mmj.v18i4.10920","volume":"18","author":"S Munasinghe","year":"2007","unstructured":"Munasinghe S. Anaemia in pregnancy in Malawi - A review. Mal Med J. 2007;18(4):160\u201375.","journal-title":"Mal Med J"},{"key":"2268_CR29","doi-asserted-by":"publisher","first-page":"66","DOI":"10.12688\/gatesopenres.13631.4","volume":"6","author":"L Manda-Taylor","year":"2024","unstructured":"Manda-Taylor L, Kufankomwe M, Chatha G, Chipeta E, Mamani-Mategula E, Mwangi MN, et al. Perceptions and experiences of intravenous iron treatment for anaemia in pregnancy in malawi: a formative qualitative study. Gates Open Res. 2024;6:66.","journal-title":"Gates Open Res"},{"key":"2268_CR30","volume-title":"Malawi demographic and health survey 2015-16. Zomba","author":"National Statistical Office Malawi, ICF","year":"2017","unstructured":"National Statistical Office Malawi, ICF. Malawi demographic and health survey 2015-16. Zomba. Malawi: NSO and ICF; 2017."},{"issue":"8","key":"2268_CR31","doi-asserted-by":"publisher","first-page":"e16697","DOI":"10.2196\/16697","volume":"9","author":"M Karra","year":"2020","unstructured":"Karra M, Canning D. The effect of improved access to family planning on postpartum women: protocol for a randomized controlled trial. JMIR Res Protocols. 2020;9(8):e16697.","journal-title":"JMIR Res Protocols"},{"issue":"22","key":"2268_CR32","doi-asserted-by":"publisher","first-page":"e2200279119","DOI":"10.1073\/pnas.2200279119","volume":"119","author":"M Karra","year":"2022","unstructured":"Karra M, Maggio D, Guo M, Ngwira B, Canning D. The causal effect of a family planning intervention on women\u2019s contraceptive use and birth spacing. Proc Natl Acad Sci USA. 2022;119(22):e2200279119.","journal-title":"Proc Natl Acad Sci USA"},{"key":"2268_CR33","volume-title":"ICF Macro. Malawi demographic and health survey 2010","author":"National Statistical Office (NSO)","year":"2011","unstructured":"National Statistical Office (NSO). ICF Macro. Malawi demographic and health survey 2010. Malawi and Calverton, MD: NSO and ICF Macro;: Zomba; 2011."},{"key":"2268_CR34","unstructured":"Vampire scare prompts U.N. pullout from southern Malawi. Reuters. 2017. Available from: https:\/\/www.reuters.com\/article\/us-malawi-un-vampires-idUSKBN1CE25E."},{"issue":"6","key":"2268_CR35","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.2307\/1911420","volume":"49","author":"A Nakamura","year":"1981","unstructured":"Nakamura A, Nakamura M. On the relationships among several specification error tests presented by Durbin, Wu, and Hausman. Econometrica. 1981;49(6):1583\u20138.","journal-title":"Econometrica"},{"key":"2268_CR36","unstructured":"Greene WH. Econometric Analysis. 4th Edition. New Jersey: Pearson; 2000."},{"key":"2268_CR37","unstructured":"World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva, Switzerland: World Health Organization; 2011."},{"key":"2268_CR38","doi-asserted-by":"crossref","unstructured":"Allison PD. Fixed effects regression models. Thousand Oaks, Calif.: SAGE; 2009;167.","DOI":"10.4135\/9781412993869"},{"key":"2268_CR39","unstructured":"Government of Malawi. National Multisector Nutrition Policy, 2025\u20132030. Lilongwe, Malawi: Ministry of Health; 2025."},{"key":"2268_CR40","unstructured":"Malawi Ministry of Health. Malawi Sexual and Reproductive Health Strategy, 2011\u20132016. Lilongwe, Malawi: Ministry of Health; 2011."},{"key":"2268_CR41","unstructured":"Malawi Ministry of Health. Malawi National Sexual and Reproductive Health and Rights (SRHR) Policy. Lilongwe, Malawi: Ministry of Health; 2009."}],"container-title":["Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12978-026-02268-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-026-02268-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-026-02268-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T11:35:48Z","timestamp":1770982548000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12978-026-02268-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2268"],"URL":"https:\/\/doi.org\/10.1186\/s12978-026-02268-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3490479\/v1","asserted-by":"object"}]},"ISSN":["1742-4755"],"issn-type":[{"value":"1742-4755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]},"assertion":[{"value":"25 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval to conduct the study was received from the Harvard University Institutional Review Board (protocol number IRB16-0421) and from the Malawi National Health Sciences Research Committee (protocol number 16\/7\/1628). Written informed consent to participate in the study was obtained, and only women who consented were recruited into the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"44"}}