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Altered maternal haemoglobin levels during pregnancy are associated with pre-clinical and clinical conditions affecting the fetus. Evidence from animal models suggests that these associations may be partially explained by differential DNA methylation in the newborn with possible long-term consequences. To test this in humans, we meta-analyzed the epigenome-wide associations of maternal haemoglobin levels during pregnancy with offspring DNA methylation in 3,967 newborn cord blood and 1,534 children and 1,962 adolescent whole-blood samples derived from 10 cohorts. DNA methylation was measured using Illumina Infinium Methylation 450K or MethylationEPIC arrays covering 450,000 and 850,000 methylation sites, respectively. There was no statistical support for the association of maternal haemoglobin levels with offspring DNA methylation either at individual methylation sites or clustered in regions. For most participants, maternal haemoglobin levels were within the normal range in the current study, whereas adverse perinatal outcomes often arise at the extremes. Thus, this study does not rule out the possibility that associations with offspring DNA methylation might be seen in studies with more extreme maternal haemoglobin levels.

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Prior research on assessing intergenerational influences on child anaemia has largely approached it from purely maternal perspective. Although there is much merit to focus on that, it is an extremely limited/reductionist view of understanding intergenerational influences. We expanded the intergenerational influences to include the fathers and overall of intergenerational household transfers. We analysed a sample of 19,619 mother-father-offspring trios from the 2015-2016 Indian National Fertility and Health Survey with available data on haemoglobin (Hb). Multinomial logistic regression models were used to establish associations between parent anaemia, household characteristics, and categories of offspring anaemia. Maternal and paternal Hb was measured as in children using a finger prick blood sample. The primary outcome was child's Hb level (in g/dl) and grades of anaemia defined as mild (10-10.9 g/dl), moderate (7-9.9 g/dl), and severe (<7 g/dl). Mean Hb was 10.1 g/dl for children, 14.2 g/dl among fathers, and 11.4 g/dl among mothers. Hb correlation was 0.1 between fathers and offspring and 0.2 between mothers and offspring (P < 0.001 for all correlations). Maternal-paternal Hb correlations were consistent across quintiles of wealth index. Maternal anaemia was associated with odds ratio of 1.3 (95% CI [1.1, 1.4]) and 1.6 (95% CI [1.4, 1.7]) for childhood mild and moderate/severe anaemia, respectively. Paternal mild anaemia was associated with an odds ratio of 1.1 (95% CI [0.9, 1.4]) and 1.4 (95% CI [1.2, 1.7]) for child moderate/severe anaemia. The clustering of poor circumstances suggests that public health strategies target social deprivation at the household level. A comprehensive perspective will provide holistic interventions to control childhood anaemia.

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BACKGROUND: Stillbirths are insufficiently reported in many countries. In Nablus, reporting has recently started; little is published in Palestine on the stillbirth rate and its risk factors. OBJECTIVE: To study the rate of stillbirths at Rafidia Hospital in 2010 and some of its risk factors. DESIGN: A retrospective cohort design. METHODS: Data were collected from the delivery registry for all births and we analysed those with a gestation of 28 weeks or more at Rafidia Hospital. Stillbirth rates were estimated for available determinants. RESULTS: In 2010, a total of 5,644 women gave birth to 5,782 babies, of whom 41 were stillbirths, that is, a stillbirth rate of 7.1/1,000 births (95% confidence interval 5.2-9.5). Premature babies had a higher risk of being a stillbirth. For small babies, the lower the birth weight the higher was the probability of being a stillbirth, and for babies weighing 4,500 g or more there was a higher risk of being stillborn. The risk of stillbirth was also higher among babies from mothers with high haemoglobin concentration, but low maternal haemoglobin was not associated with stillbirths. CONCLUSIONS: The stillbirth rates at Rafidia hospital assessed in this study compares favourably with the reported national numbers, indicating a good reliability of the on-going registration. The rates were highest among premature births. Stillbirth was linked to low birth weight, foetal macrosomia, and maternal haemoconcentration. We believe the findings identify areas to address when designing antenatal care with the aim of improving perinatal mortality in the country.

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BACKGROUND: Maternal measles antibodies (MMA) are actively transferred through the placenta from mother to foetus. A relationship could exist between MMA of mother-infant pairs and maternal nutritional indicator (haemoglobin). OBJECTIVES: This study reviewed the effects of maternal haemoglobin (Hb) on MMA of mother-infant pairs at birth. METHODS: One hundred and fifty three mother-infant pairs were enrolled in this study using the systematic random sampling method. Means of maternal Hb and MMA of mother-infant pairs were compared using the Student t test. Correlation coefficients of maternal Hb and MMA of mother-infant pairs were also determined. Multivariate analysis of variable (MANOVA) and covariates (MANCOVA) was used to investigate the effects of maternal Hb (fixed factor), gestational age, maternal age, birth weight (covariates) on combined MMA of mother-infant pairs (dependent factors). Benferroni adjusted Univariate linear regression was used to investigate the dependent variables separately. RESULTS: There were 78 (51%) males and 75 (49%) females. The (mean ± SD) MMA of mother-infant pairs at birth were 134.66 ± 93.31 (95% CI, 119.76 - 149.56) U/ml, and 187.49 ± 85.01 (95% CI, 173.91 - 201.07) U/ml, and their correlation was significant (p = 0.025). Ninety one (59.5 %) mothers had low Hb, 62 (40.5 %) had acceptable Hb levels. The overall mean maternal Hb was 11.01 ± 1.00 (95% CI, 10.85 - 11.17) g/dl . A positive significant correlation was observed between maternal Hb and MMA of the newborn-infant (p = 0.031). The MANOVA showed a statistically significant difference between maternal Hb on the combined dependent variables (p =0.033); however, results for the dependent variables using the Benferroni adjusted Univariate analysis was significant for only MMA of the infants, (p = 0.009). CONCLUSION: There was a significant association between aacceptable levels of maternal Hb and high MMA of the newborn-infants. Therefore, these newborn infants start out with higher MMA that could give them better protection against measles during infancy.

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This prospective, cross sectional population study was carried out to determine the relationship between maternal haemoglobin concentration and birth weight in different socioeconomic groups in a tertiary care teaching hospital. 500 cases each from two teaching hospitals about whom information on socioeconomic status, haemoglobin concentration and birth weight was known were included in the study. This was a stratified random study based on the preselected inclusion and exclusion criteria. 149 (14.9%) women belonged to upper socioeconomic group, 119 (11.9%) to upper middle, 125 (12.5%) to lower middle, 90 (9.0%) to upper lower and 517 (51.7%) to lower group. Mean haemoglobin level was found to be lower in low socioeconomic group as compared to high socioeconomic group and was statistically significant (F value of 18.2521 & p 0.000). The lowest Hb level was 4.0g/dl and highest was 15.0g/dL Majority of pregnant women (89.3%) had their lowest haemoglobin level during the second trimester as compared to first trimester (0.8%) and third trimester (9.9%). The mean birth weight in upper socioeconomic group was 2.7508 kg, 2.7556 kg in upper middle group, 2.8802 kg in lower middle group, 2.7876 kg in upper lower group and 2.7515 in lower socioeconomic group. By analysis of variance test it was found that the mean birth weight did not vary significantly between different socioeconomic groups with an F value of 1.3398 and p value of 0.2450. The correlation analysis of haemoglobin concentration with birth weight suggested that for every rise of haemoglobin concentration by 1.0g/dl the birth weight reduced by 03839 kg (highly significant p < 0.001). In the present study there was significant inverse relationship of maternal haemoglobin concentration to birth weight Results are in agreement with the hypothesis that a higher blood viscosity is a risk factor for sub optimal placenta-perfusion.