Low Haemoglobin in Arduous Seasons is Associated with Reduced Chance of Ovulation Among Women Living in the Bolivian

Overview

Journal Evol Med Public Health

Publisher Oxford University Press

Specialty General Medicine

Date 2024 Oct 24

PMID 39444585

Authors

Rose Stevens

Alexandra Alvergne

Virginia J Vitzthum

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Female reproductive function flexibly responds to ecological variation in energy availability, but the roles of other ecologically limited resources, such as iron, remain poorly understood. This analysis investigates whether haemoglobin associates with investment in reproductive function in a rural natural fertility population living in the Bolivian .

Methodology: We conducted a cross-sectional secondary analysis of prospectively collected biomarker and sociodemographic data, comprising 152 menstrual cycles from 96 non-contracepting women living at 3800 m altitude. Multivariable multilevel models were used to investigate (i) whether haemoglobin concentration is associated with ecological variation in subsistence strategy and seasonal conditions, and (ii) whether haemoglobin concentration is associated with the occurrence of ovulation and/or the concentration of luteal progesterone, two biomarkers of current investment in reproduction.

Results: Haemoglobin concentrations were lower in arduous seasons among those women more dependent on traditional agropastoral subsistence strategies ( = -0.42, 95% CI: -0.80 to -0.04, = 0.032). During more arduous seasons, a 1 standard deviation increase in haemoglobin was associated with an over 3-fold increase in the odds of ovulation after adjusting for body fat, breastfeeding status, and age (adjusted odds ratio = 3.27, 95% CI: 1.10 to 9.27, = 0.033).

Conclusions And Implications: When conditions are relatively harsh and may be expected to improve, low haemoglobin levels are associated with lower current investment in reproduction and reduced fecundity. These results support the role of iron, independent of energy stores, as a limiting resource in modulating reproductive trade-offs.

References

Beall C, Brittenham G, Strohl K, Blangero J, Williams-Blangero S, Goldstein M . Hemoglobin concentration of high-altitude Tibetans and Bolivian Aymara. Am J Phys Anthropol. 1998; 106(3):385-400. DOI: 10.1002/(SICI)1096-8644(199807)106:3<385::AID-AJPA10>3.0.CO;2-X. View

Petry N, Olofin I, Hurrell R, Boy E, Wirth J, Moursi M . The Proportion of Anemia Associated with Iron Deficiency in Low, Medium, and High Human Development Index Countries: A Systematic Analysis of National Surveys. Nutrients. 2016; 8(11). PMC: 5133080. DOI: 10.3390/nu8110693. View

Vitzthum V, Thornburg J, Spielvogel H . Seasonal modulation of reproductive effort during early pregnancy in humans. Am J Hum Biol. 2009; 21(4):548-58. DOI: 10.1002/ajhb.20936. View

Caravedo M, Cabada M . Human Fascioliasis: Current Epidemiological Status and Strategies for Diagnosis, Treatment, and Control. Res Rep Trop Med. 2020; 11:149-158. PMC: 7705270. DOI: 10.2147/RRTM.S237461. View

Clancy K, Nenko I, Jasienska G . Menstruation does not cause anemia: endometrial thickness correlates positively with erythrocyte count and hemoglobin concentration in premenopausal women. Am J Hum Biol. 2006; 18(5):710-3. DOI: 10.1002/ajhb.20538. View

Gangaidzo I, Moyo V, Mvundura E, Aggrey G, Murphree N, Khumalo H . Association of pulmonary tuberculosis with increased dietary iron. J Infect Dis. 2001; 184(7):936-9. DOI: 10.1086/323203. View

Lunn P, Austin S, Prentice A, Whitehead R . The effect of improved nutrition on plasma prolactin concentrations and postpartum infertility in lactating Gambian women. Am J Clin Nutr. 1984; 39(2):227-35. DOI: 10.1093/ajcn/39.2.227. View

Angeli A, Laine F, Lavenu A, Ropert M, Lacut K, Gissot V . Joint Model of Iron and Hepcidin During the Menstrual Cycle in Healthy Women. AAPS J. 2016; 18(2):490-504. PMC: 4779110. DOI: 10.1208/s12248-016-9875-4. View

Miller E . The reproductive ecology of iron in women. Am J Phys Anthropol. 2016; 159(Suppl 61):S172-95. DOI: 10.1002/ajpa.22907. View

10.

Hernan M . The C-Word: Scientific Euphemisms Do Not Improve Causal Inference From Observational Data. Am J Public Health. 2018; 108(5):616-619. PMC: 5888052. DOI: 10.2105/AJPH.2018.304337. View

11.

Chaparro C, Suchdev P . Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019; 1450(1):15-31. PMC: 6697587. DOI: 10.1111/nyas.14092. View

12.

Vitzthum V, Spielvogel H, Thornburg J . Interpopulational differences in progesterone levels during conception and implantation in humans. Proc Natl Acad Sci U S A. 2004; 101(6):1443-8. PMC: 341739. DOI: 10.1073/pnas.0302640101. View

13.

Gassmann M, Mairbaurl H, Livshits L, Seide S, Hackbusch M, Malczyk M . The increase in hemoglobin concentration with altitude varies among human populations. Ann N Y Acad Sci. 2019; 1450(1):204-220. DOI: 10.1111/nyas.14136. View

14.

Vitzthum V . Field methods and strategies for assessing female reproductive functioning. Am J Hum Biol. 2020; 33(5):e23513. DOI: 10.1002/ajhb.23513. View

15.

Kolesarova A, Capcarova M, Medvedova M, Sirotkin A, Kovacik J . In vitro assessment of iron effect on porcine ovarian granulosa cells: secretory activity, markers of proliferation and apoptosis. Physiol Res. 2011; 60(3):503-10. DOI: 10.33549/physiolres.931969. View

16.

Miller E . Maternal hemoglobin depletion in a settled northern Kenyan pastoral population. Am J Hum Biol. 2010; 22(6):768-74. DOI: 10.1002/ajhb.21078. View

17.

Scholl T . Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr. 2005; 81(5):1218S-1222S. DOI: 10.1093/ajcn/81.5.1218. View

18.

Tennant P, Murray E, Arnold K, Berrie L, Fox M, Gadd S . Use of directed acyclic graphs (DAGs) to identify confounders in applied health research: review and recommendations. Int J Epidemiol. 2020; 50(2):620-632. PMC: 8128477. DOI: 10.1093/ije/dyaa213. View

19.

Vitzthum V, Spielvogel H . Epidemiological transitions, reproductive health, and the Flexible Response Model. Econ Hum Biol. 2004; 1(2):223-42. DOI: 10.1016/S1570-677X(03)00037-6. View

20.

Safiri S, Kolahi A, Noori M, Nejadghaderi S, Karamzad N, Bragazzi N . Burden of anemia and its underlying causes in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. J Hematol Oncol. 2021; 14(1):185. PMC: 8567696. DOI: 10.1186/s13045-021-01202-2. View