Iron Status and Reproduction in US Women: National Health and Nutrition Examination Survey, 1999-2006
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{"title"=>"Iron status and reproduction in US women: National health and nutrition examination survey, 1999-2006", "type"=>"journal", "authors"=>[{"first_name"=>"Elizabeth M.", "last_name"=>"Miller", "scopus_author_id"=>"35322618100"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84910675577", "pui"=>"600434812", "sgr"=>"84910675577", "issn"=>"19326203", "pmid"=>"25375360", "doi"=>"10.1371/journal.pone.0112216"}, "id"=>"4655147d-9612-3ede-97f1-b87d9589c369", "abstract"=>"Women experience significant changes in iron status throughout their reproductive lifespans. While this is evident in regions with high rates of malnutrition and infectious disease, the extent of reproductive-related changes is less well known in countries with low rates of iron deficiency anemia, such as the United States. The goal of this study is determine the relationship between women's reproductive variables (pregnancy, parity, currently breastfeeding, regular menstruation, hormonal contraceptive use, and age at menarche) and iron status (hemoglobin, ferritin, transferrin receptor, and % transferrin saturation) using an anthropological framework for interpreting the results. Data from women aged 18-49 were taken from the 1999-2006 US NHANES, a nationally representative cross-sectional sample of US women. Using multiple imputation and complex survey statistics, women's reproductive variables were regressed against indicators of iron status. Pregnant women had significantly poorer iron status, by most indicators, than non-pregnant women. All biomarkers demonstrated significantly lower iron levels with increasing parity. Women who were having regular periods had iron indicators that suggested decreased iron levels, while women who used hormonal contraceptives had iron indicators that suggested increased iron levels. Despite relatively good iron status and widespread availability of iron-rich foods in the US, women still exhibit patterns of iron depletion across several reproductive variables of interest. These results contribute to an ecological approach to iron status that seeks to understand variation in iron status, with the hopes that appropriate, population-specific recommendations can be developed to improve women's health.", "link"=>"http://www.mendeley.com/research/iron-status-reproduction-women-national-health-nutrition-examination-survey-19992006-1", "reader_count"=>35, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>2, "Researcher"=>3, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>5, "Student > Postgraduate"=>4, "Other"=>4, "Student > Master"=>8, "Student > Bachelor"=>7}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>2, "Researcher"=>3, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>5, "Student > Postgraduate"=>4, "Other"=>4, "Student > Master"=>8, "Student > Bachelor"=>7}, "reader_count_by_subject_area"=>{"Biochemistry, Genetics and Molecular Biology"=>3, "Nursing and Health Professions"=>5, "Medicine and Dentistry"=>14, "Agricultural and Biological Sciences"=>8, "Sports and Recreations"=>1, "Social Sciences"=>3, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>14}, "Social Sciences"=>{"Social Sciences"=>3}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>5}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>3}}, "group_count"=>2}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1782560"], "description"=>"a<p>The <i>n</i> for the hemoglobin, ferritin, and % transferrin saturation model is 6603 (all years).</p>b<p>The <i>n</i> for the transferrin receptor model is 3295 (survey years 2003–2006 only).</p>c<p>Mean R<sup>2</sup> of 50 imputations.</p>d<p>Reference category is white ethnicity.</p>e<p>Reference category is survey release year 1999–2000 (hemoglobin, ferritin, and % transferrin saturation models).</p>f<p>Reference category is survey release year 2003–2004 (transferrin receptor model only).</p><p>Weighted estimates, 95% confidence intervals, and p-values for imputed survey regression models of hemoglobin, ferritin, % transferrin saturation, and transferrin receptor as dependent variables, reproductive variables as independent variables, and ethnicity, survey release year, and other covariates as control variables.</p>", "links"=>[], "tags"=>["iron levels", "Iron deficiency anemia", "iron indicators", "Nutrition Examination Survey", "nhanes", "iron status"], "article_id"=>1231518, "categories"=>["Biological Sciences"], "users"=>["Elizabeth M. Miller"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112216.t004", "stats"=>{"downloads"=>2, "page_views"=>23, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_estimates_95_confidence_intervals_and_p_values_for_imputed_survey_regression_models_of_hemoglobin_ferritin_transferrin_saturation_and_transferrin_receptor_as_dependent_variables_reproductive_variables_as_independent_variables_and_ethnicity_surve/1231518", "title"=>"Weighted estimates, 95% confidence intervals, and p-values for imputed survey regression models of hemoglobin, ferritin, % transferrin saturation, and transferrin receptor as dependent variables, reproductive variables as independent variables, and ethnicity, survey release year, and other covariates as control variables.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-06 04:47:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/1782557"], "description"=>"a<p>All <i>n</i>  =  6603 (except transferrin receptor).</p>b<p>The <i>n</i> for the imputed mean for transferrin receptor is 3295; based on 2003–2006 survey years only.</p>c<p>All variables were available in original data set, so no 95% CI were generated by PROC MIANALYZE.</p><p>Weighted descriptive statistics for study variables for women aged 18–49 who participated in the NHANES physical examination during 1999–2006, before and after multiple imputation of missing values.</p>", "links"=>[], "tags"=>["iron levels", "Iron deficiency anemia", "iron indicators", "Nutrition Examination Survey", "nhanes", "iron status"], "article_id"=>1231515, "categories"=>["Biological Sciences"], "users"=>["Elizabeth M. Miller"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112216.t001", "stats"=>{"downloads"=>5, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_descriptive_statistics_for_study_variables_for_women_aged_18_8211_49_who_participated_in_the_NHANES_physical_examination_during_1999_8211_2006_before_and_after_multiple_imputation_of_missing_values_/1231515", "title"=>"Weighted descriptive statistics for study variables for women aged 18–49 who participated in the NHANES physical examination during 1999–2006, before and after multiple imputation of missing values.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-06 04:47:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/1782556"], "description"=>"<p>Weighted (unimputed) means and ±1 standard error of the mean for measures of iron status by parity.</p>", "links"=>[], "tags"=>["iron levels", "Iron deficiency anemia", "iron indicators", "Nutrition Examination Survey", "nhanes", "iron status"], "article_id"=>1231514, "categories"=>["Biological Sciences"], "users"=>["Elizabeth M. Miller"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112216.g002", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_unimputed_means_and_177_1_standard_error_of_the_mean_for_measures_of_iron_status_by_parity_/1231514", "title"=>"Weighted (unimputed) means and ±1 standard error of the mean for measures of iron status by parity.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-06 04:47:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/1782559"], "description"=>"a<p>Transferrin receptor model is based on survey years 2003–2006 only.</p>b<p>Reference category is white ethnicity.</p>c<p>Reference category is survey release year 1999–2000 (hemoglobin, ferritin, and % transferrin saturation models).</p>d<p>Reference category is survey release year 2003–2004 (transferrin receptor model only).</p><p>Weighted estimates and p-values for complete case survey regression models of hemoglobin, ferritin, % transferrin saturation, and transferrin receptor as dependent variables, reproductive variables as independent variables, and ethnicity, survey release year, and other covariates as control variables.</p>", "links"=>[], "tags"=>["iron levels", "Iron deficiency anemia", "iron indicators", "Nutrition Examination Survey", "nhanes", "iron status"], "article_id"=>1231517, "categories"=>["Biological Sciences"], "users"=>["Elizabeth M. Miller"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112216.t003", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_estimates_and_p_values_for_complete_case_survey_regression_models_of_hemoglobin_ferritin_transferrin_saturation_and_transferrin_receptor_as_dependent_variables_reproductive_variables_as_independent_variables_and_ethnicity_survey_release_year_and/1231517", "title"=>"Weighted estimates and p-values for complete case survey regression models of hemoglobin, ferritin, % transferrin saturation, and transferrin receptor as dependent variables, reproductive variables as independent variables, and ethnicity, survey release year, and other covariates as control variables.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-06 04:47:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/1782558"], "description"=>"a<p>Percentages based on 2003–2006 survey years only.</p>b<p>Calculated based on percentage of women who had two of three values (hemoglobin, ferritin, and % transferrin saturation) below cutoff.</p><p>Non-imputed, weighted percentages of NHANES women who are below iron indicator cutoffs by pregnancy status (See <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0112216#pone-0112216-t001\" target=\"_blank\">Table 1</a> for number of non-missing values in each category).</p>", "links"=>[], "tags"=>["iron levels", "Iron deficiency anemia", "iron indicators", "Nutrition Examination Survey", "nhanes", "iron status"], "article_id"=>1231516, "categories"=>["Biological Sciences"], "users"=>["Elizabeth M. Miller"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112216.t002", "stats"=>{"downloads"=>3, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Non_imputed_weighted_percentages_of_NHANES_women_who_are_below_iron_indicator_cutoffs_by_pregnancy_status_See_Table_1_for_number_of_non_missing_values_in_each_category_/1231516", "title"=>"Non-imputed, weighted percentages of NHANES women who are below iron indicator cutoffs by pregnancy status (See Table 1 for number of non-missing values in each category).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-06 04:47:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/1782554"], "description"=>"<p>Weighted (unimputed) means and ±1 standard error of the mean for measures of iron status by pregnancy status.</p>", "links"=>[], "tags"=>["iron levels", "Iron deficiency anemia", "iron indicators", "Nutrition Examination Survey", "nhanes", "iron status"], "article_id"=>1231512, "categories"=>["Biological Sciences"], "users"=>["Elizabeth M. Miller"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0112216.g001", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_unimputed_means_and_177_1_standard_error_of_the_mean_for_measures_of_iron_status_by_pregnancy_status_/1231512", "title"=>"Weighted (unimputed) means and ±1 standard error of the mean for measures of iron status by pregnancy status.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-06 04:47:23"}

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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences/Pediatrics", "average_usage"=>[304, 478]}]}
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