Associations Between Clinical, Diet, and Social Determinants of Health and Hemoglobin and Anemia in Early Pregnancy

Objectives: To investigate associations among clinical, diet, and social determinants of health on hemoglobin and anemia in early pregnancy in a diverse urban population. Methods: Fifty-one pregnant women were recruited at the University of Illinois Health and Hospital System Chicago, IL. Early pregnancy hemoglobin was measured at 10.3 ± 3 gestational weeks. Participants completed a validated food frequency questionnaire at 14.7 ± 6 gestational weeks to assess habitual intake during the past month. Participants provided demographic information and clinical data was extracted from electronic health records. Neighborhood data including unemployment rate, uninsured rate, pollution μg/m2 of PM2.5, and food access defined as % of residents with low access to food by distance were obtained from the Chicago Health Atlas. Descriptive and inferential statistics predicting hemoglobin and anemia were established using linear and logistic models. Results: The sample was 27% Hispanic/Latino, 51% Black, and 16% White with a mean age of 30 ± 5.9 years, mean BMI of 29 ± 6.8 kg/m2, and mean hemoglobin of 12.5 ± 1.1 g/dl. In a multivariable model, BMI was an independent positive predictor, and neighborhood level uninsured rate was an independent inverse predictor of hemoglobin when controlling for maternal age, HEI-2015, hemoglobin assessment gestational age, Black vs. other race and neighborhood level unemployment rate. In a logistic model predicting anemia (hemoglobin < 12.0 g/dL) BMI was associated with decreased odds and neighborhood level unemployment rate with increased odds of anemia when controlling for maternal age, HEI-2015, hemoglobin assessment gestational age, Black vs. other race and neighborhood level uninsured rate. Conclusions: Neighborhood quality is related to early pregnancy hemoglobin levels and anemia. Addressing disparities in social determinants of health may be necessary for mitigating risks of iron deficiency in early pregnancy. Funding Sources: R03HD095056, Mid America Minority Serving Institutes Training Consortium for Maternal Child Health Nutrition-Fellowship.