{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T16:47:03Z","timestamp":1793378823563,"version":"4.5.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T00:00:00Z","timestamp":1643760000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Low birth weight (LBW) is associated with a higher risk of neonatal mortality and the development of adult-onset chronic disease. Understanding the ongoing contribution of maternal hemoglobin (Hgb) levels to the incidence of LBW in South Asia is crucial to achieve the World Health Assembly global nutrition target of a 30% reduction in LBW by 2025. We enrolled pregnant women from the rural Tangail District of Bangladesh in a Maternal Newborn Health Registry established under The Global Network for Women\u2019s and Children\u2019s Health Research. We measured the Hgb of pregnant women at enrollment and birth weights of all infants born after 20 weeks gestation. Using logistic regression to adjust for multiple potential confounders, we estimated the association between maternal Hgb and the risk of LBW. We obtained Hgb measurements and birth weights from 1,665 mother\u2013child dyads between July 2019 and April 2020. Using trimester-specific cutoffs for anemia, 48.3% of the women were anemic and the mean (\u00b1SD) Hgb level was 10.6 (\u00b11.24) g\/dL. We identified a U-shaped relationship where the highest risk of LBW was seen at very low (&lt;\u20097.0 g\/dL, OR = 2.00, 95% CI = 0.43\u20137.01, <jats:italic>P<\/jats:italic> = 0.31) and high (&gt; 13.0 g\/dL, OR = 2.17, 95% CI = 1.01\u20134.38, <jats:italic>P<\/jats:italic> = 0.036) Hgb levels. The mechanisms underlying this U-shaped association may include decreased plasma expansion during pregnancy and\/or iron dysregulation resulting in placental disease. Further research is needed to explain the observed U-shaped relationship, to guide iron supplementation in pregnancy and to minimize the risk of LBW outcomes.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0268","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T17:27:32Z","timestamp":1638206852000},"page":"424-431","source":"Crossref","is-referenced-by-count":17,"title":["U-Shaped Association between Maternal Hemoglobin and Low Birth Weight in Rural Bangladesh"],"prefix":"10.4269","volume":"106","author":[{"given":"Rebecca M.","family":"Carpenter","sequence":"first","affiliation":[{"name":"1Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sk Masum","family":"Billah","sequence":"additional","affiliation":[{"name":"2The International Center for Diarrhoeal Disease and Research, Dhaka, Bangladesh;"},{"name":"3The University of Sydney School of Public Health, Sydney, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve R.","family":"Lyons","sequence":"additional","affiliation":[{"name":"4Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Shahjahan","family":"Siraj","sequence":"additional","affiliation":[{"name":"2The International Center for Diarrhoeal Disease and Research, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qazi S.","family":"Rahman","sequence":"additional","affiliation":[{"name":"2The International Center for Diarrhoeal Disease and Research, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Thorsten","sequence":"additional","affiliation":[{"name":"5RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"McClure","sequence":"additional","affiliation":[{"name":"5RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashidul","family":"Haque","sequence":"additional","affiliation":[{"name":"2The International Center for Diarrhoeal Disease and Research, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Petri","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/2\/article-p424.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/106\/2\/article-p424.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T14:58:31Z","timestamp":1643813911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/2\/article-p424.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,2]]},"references-count":0,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0268","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,2]]}}}