{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:23Z","timestamp":1787022083400,"version":"build-2736575974"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007886","name":"Fondation Nestl\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007886","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Iron Deficiency Anaemia (IDA) is reportedly high in pregnant adults and the causes well studied. However, among pregnant teenagers, the levels and associated factors of IDA are not fully understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective cohort study among Ghanaian pregnant teenagers, aged 13\u201319 years, IDA prevalence and associated factors were investigated. Sociodemographic data, household hunger scale (HHS), lived poverty index (LPI), FAO\u2019s women\u2019s dietary diversity score (WDDS) and interventions received during antenatal care (ANC) were obtained from 416 pregnant teenagers in Ashanti Region, Ghana. Micronutrient intakes using a repeated 24-hour dietary recall, and mid-upper arm circumference (MUAC) were determined and blood samples analysed for haemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, total antioxidant capacity (TAC), C-reactive protein (CRP), and zinc protoporphyrin (ZPP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Anaemia (Hb cutoff &lt;11.0 g\/dL) was 57.1%; deficient systemic supply of iron stores (31.4%), depleted body stores of iron (4.4%), inadequate dietary iron intake (94.5%), and inadequate multiple micronutrient intakes (49.5%), were all notable among study participants. Between-subject effects using Generalized Linear Modelling indicated malaria tablet given at ANC (p = 0.035), MUAC (p = 0.043), ZPP (p&lt;0.001), ZPP\/Hb ratio (p&lt;0.001) and depleted body iron stores (DBIS) (p&lt;0.001) to significantly affect Hb levels. Pregnant teenagers with a high ZPP\/Hb ratio (OR = 9.7, p&lt;0.001, 95%CI = 6.0\u201315.8) had increased odds of being anaemic compared to those with normal ZPP\/Hb ratio. Participants who were wasted (OR = 1.2, p = 0.543, 95%CI = 0.6\u20132.3), and those with depleted iron stores (OR = 3.0, p = 0.167, 95%CI = 0.6\u201314.6) had increased odds of being anaemic. Participants who experienced hunger were close to 3 times more likely (OR = 2.9, p = 0.040, 95%CI = 1.1\u20137.8) for depleted iron stores, compared to those who did not experience hunger. Also, participants with inadequate multiple micronutrients intakes (OR = 2.6, p = 0.102, 95%CI = 0.8\u20138.4), and those with low serum levels of ferritin (OR = 3.3, p = 0.291, 95%CI = 0.4\u201329.2) had increased odds of depleted body iron stores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IDA is common among pregnant teenagers and the related factors include malaria tablets given at ANC, maternal hunger, maternal MUAC, a deficient systemic supply of iron, depleted body iron stores, ZPP, and ZPP\/Hb ratio. Appropriate interventions are urgently needed to address the causes of IDA among pregnant teenagers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0250246","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T14:41:15Z","timestamp":1619534475000},"page":"e0250246","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":39,"title":["Factors associated with iron deficiency anaemia among pregnant teenagers in Ashanti Region, Ghana: A hospital-based prospective cohort study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8040-9396","authenticated-orcid":true,"given":"Reginald Adjetey","family":"Annan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda Afriyie","family":"Gyimah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4071-5049","authenticated-orcid":true,"given":"Charles","family":"Apprey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Kwaku","family":"Edusei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odeafo","family":"Asamoah-Boakye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda Nana Esi","family":"Aduku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wisdom","family":"Azanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman E.","family":"Lutterodt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"key":"pone.0250246.ref001","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1038\/nature25770","article-title":"Importance of investing in adolescence from a developmental science perspective","volume":"554","author":"RE Dahl","year":"2018","journal-title":"Nature"},{"key":"pone.0250246.ref002","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/S2352-4642(19)30110-5","article-title":"Social, biological, and programmatic factors linking adolescent pregnancy and early childhood undernutrition: a path analysis of India\u2019s 2016 National Family and Health Survey","volume":"3","author":"PH Nguyen","year":"2019","journal-title":"Lancet Child Adolescent Health"},{"key":"pone.0250246.ref003","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1186\/s12978-017-0443-x","article-title":"The long-term effects of adolescent pregnancies in a community in Northern Ghana on subsequent pregnancies and births of the young mothers","volume":"14","author":"A Yussif","year":"2017","journal-title":"Reprod Health"},{"key":"pone.0250246.ref004","author":"World Health Organization","year":"2019","journal-title":"Adolescent pregnancy"},{"key":"pone.0250246.ref005","unstructured":"Ghana Statistical Service (GSS), Ghana Health Service (GHS), ICF Macro. 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