Lower hemoglobin levels in first time mothers from Cebu, Philippines

The association between parity and hemoglobin status in mothers is unclear. Closely spaced pregnancies may predict decreased hemoglobin in women, as these shorter intervals may limit the time available for iron repletion, or maternal age may be associated with general declines in hemoglobin. This study investigated the association between parity and hemoglobin status in a 1-year birth cohort of mothers from Cebu, Philippines, with variable parities. It was hypothesized that maternal parity would be inversely associated with hemoglobin status and that among multiparous mothers, interbirth interval, and prior breastfeeding duration would be positively associated with hemoglobin level.

The study design was cross-section with participants (n = 125) recruited from the Cebu Longitudinal Health and Nutrition Survey; all mothers were 24-25 years of age at the time of the study and currently breastfeeding infants less than 3 years of age. Hemoglobin was measured using B-Hemocue Analyzer. Detailed dietary information, health recalls, anthropometrics, and reproductive histories were available on all mothers.

Maternal parity ranged from 1 to 6 with an average of 2.2 (1.0) births. In this cross section of parity among similarly aged women, hemoglobin levels were significantly lower for primiparous (12.1 ± 1.8) compared to multiparous mothers (13.2 ± 1.5; P = 0.03), despite similar antianemic usage during gestation. There was no significant association between prior interbirth interval, prior, or current breastfeeding duration and hemoglobin in multiparas.

Low hemoglobin levels of primiparous women in this sample might indicate increased nutritional stress associated with first pregnancy.