Iron intake and anemia as predictors of preeclampsia risk in pregnant women in the second trimester

Salmah Arafah* -  Medical Department of Nursing Study Program, Tanawali Takalar Health College., Indonesia
Dewiyanti Dewiyanti -  Department of Nursing Study Programs at Tanawali Takalar Health College, Indonesia
Ernawati Ernawati -  Department Nursing Study Programs at Tanawali Takalar Health College, Indonesia
Dina Oktaviana -  Department Nursing Study Programs at Tanawali Takalar Health College, Indonesia
Kamriana Kamriana -  Department Nursing Study Programs at Tanawali Takalar Health College, Indonesia
Alwi Alwi -  Tanawali Takalar Health College, Indonesia
Zainuddin Zainuddin -  Department of Nursing, Faculty of Sport and Health, Universitas Negeri Gorontalo, Indonesia, Indonesia
Nur Hijrah Syaharani -  Medical Education Study Program, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
DOI : 10.30867/action.v10i4.2716

Preeclampsia remains one of the leading causes of maternal morbidity and mortality worldwide, including in Indonesia. Iron deficiency anemia is considered a modifiable risk factor; however, few studies have specifically examined the relationship between anemia status and iron intake and the risk of preeclampsia during the second trimester of pregnancy. This study aimed to analyze the relationship between anemia status and iron intake and the risk of preeclampsia among second-trimester pregnant women. A cross-sectional analytical design was employed involving 150 pregnant women selected through purposive sampling in the working area of Pattallassang Public Health Center, Takalar Regency, between January and March 2025. Data were collected through hemoglobin level examination, a Food Frequency Questionnaire (FFQ) for iron intake assessment, and medical records for preeclampsia diagnosis. Data were analyzed using chi-square and logistic regression tests to determine the associations and predictive strength. The results showed that 30% of respondents experienced preeclampsia, 42% had anemia, and 64% had an inadequate iron intake. Anemia and inadequate iron intake were significantly associated with an increased risk of preeclampsia (p < 0.05). In conclusion, anemia and iron intake are important predictors of preeclampsia risk, highlighting the need for nutritional screening and early intervention to prevent further complications.

Keywords : Anemia, Pregnant Women, Preeclampsia, Second Trimester, Iron

  1. Ahmed, Y. I. B., Yagoub, H. S., Hassan, M. A., Adam, I., & Hamdan, H. Z. (2023). Maternal serum iron status, hepcidin and interleukin-6 levels in women with preeclampsia. Frontiers in Physiology, 14, 1–5. https://doi.org/10.3389/fphys.2023.1049994
  2. Al-Bayyari, N., Al Sabbah, H., Hailat, M., AlDahoun, H., & Abu-Samra, H. (2024). Dietary diversity and iron deficiency anemia among a cohort of singleton pregnancies: A cross-sectional study. BMC Public Health, 24(1), 1–14. https://doi.org/10.1186/s12889-024-19294-z
  3. Alfiana, M. O., Frety, E. E., & Akbar, M. I. A. (2024). Anemia dan preeklampsia dalam kehamilan: Literature review. Malahayati Nursing Journal, 6(10), 3997–4003. https://doi.org/10.33024/mnj.v6i10.13871
  4. Apriyanti, D., Budihastuti, U. R., & Kusnandar, K. (2023). Physical activity, intake of iron and folic acid with the risk of preeclampsia. AcTion: Aceh Nutrition Journal, 8(4), 553. https://doi.org/10.30867/action.v8i4.1214
  5. Bangsa, N. K., Romdoni, R., & Subagyo, S. (2021). Clinical symptoms of patient with heart failure in Dr. Soetomo General Hospital: A descriptive study. JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga, 12(2), 61–65. https://doi.org/10.20473/juxta.v12i22021.61-65
  6. Callahan, T. J., Stefanski, A. L., Kim, J. D., Baumgartner, W. A., Wyrwa, J. M., & Hunter, L. E. (2023). Knowledge-driven mechanistic enrichment of the preeclampsia ignorome. In Pacific Symposium on Biocomputing 2023 (pp. 371–382). https://doi.org/10.1142/9789811270611_0034
  7. Dehghani, A., Molani-Gol, R., Rafraf, M., Mohammadi-Nasrabadi, F., & Khodayari-Zarnaq, R. (2024). Iron deficiency anemia status in Iranian pregnant women and children: An umbrella systematic review and meta-analysis. BMC Pregnancy and Childbirth, 24(1), 1–12. https://doi.org/10.1186/s12884-024-06575-z
  8. Dey, T., Widmer, M., Coomarasamy, A., Goudar, S. S., Berrueta, M., Coutinho, E., Gaaloul, M. El, Faden, R. R., Gülmezoglu, A. M., Justus Hofmeyr, G., Knight, M., Lamprianou, S., Mastroianni, A. C., Munoz, F. M., Oladapo, O. T., Penazzato, M., Renaud, F., Townsend, C. L., & Bonet, M. (2025). Advancing maternal and perinatal health through clinical trials: Key insights from a WHO global consultation. The Lancet Global Health, 13(4), e740–e748. https://doi.org/10.1016/S2214-109X(24)00512-6
  9. Díaz-Torres, S., Díaz-López, A., & Arija, V. (2024). Effect of prenatal iron supplementation adapted to hemoglobin levels in early pregnancy on fetal and neonatal growth: ECLIPSES study. Nutrients, 16(3). https://doi.org/10.3390/nu16030437
  10. Iswardani, O., Hakimi, M., & Kurnia, A. R. (2019). Association of iron pills consumption during pregnancy with incidence of maternal anemia in Indonesia (IFLS 5 advanced analysis study). Journal of Health Education, 4(1), 29–36. https://doi.org/10.15294/jhe.v4i1.27756
  11. Kario, K., Okura, A., Hoshide, S., & Mogi, M. (2024). The WHO global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertension Research, 47(5), 1099–1102. https://doi.org/10.1038/s41440-024-01622-w
  12. Kemenkes. (2018). Laporan Riskesdas 2018 Nasional (p. 156). Lembaga Penerbit Balitbangkes. [data tidak tersedia URL]
  13. Lewandowska, M., Sajdak, S., & Lubiński, J. (2019). Can serum iron concentrations in early healthy pregnancy be a risk marker of pregnancy-induced hypertension? Nutrients, 11(5). https://doi.org/10.3390/nu11051086
  14. Mohebi, S., Parham, M., Sharifirad, G., & Gharlipour, Z. (2018). Social support and self-care behavior study. [data tidak tersedia nama jurnal], [data tidak tersedia volume], 1–6. https://doi.org/10.4103/jehp.jehp
  15. Nanda, A. W., & Semarawisma, A. (2021). Association between anemia and preeclampsia: A case-control study in Gorontalo region, Indonesia. International Journal of Research in Medical Sciences, 10(1), 31. https://doi.org/10.18203/2320-6012.ijrms20215031
  16. Nugraha, G. B. A., Prasetyo, P. J., & Daliman. (2021). Anemia in pregnancy as a predisposing factor of severe preeclampsia anemia dalam kehamilan sebagai salah satu faktor predisposisi preeklamsia berat: Case report. Indonesian Journal of Obstetrics and Gynecology, 9(2), 7–10. [data tidak tersedia DOI]
  17. Umiastuti, P., Umijati, S., Raissa, S., Fadhil, M., Raihani, K., Fahdizar, E., Nastiti, N., Nuriana, M., Aria, S., & Nur Imanina, S. (2024). The relationship between anemia in pregnant women and the incidence of preeclampsia in Indonesia: A systematic review. Journal of Community Medicine and Public Health Research, 5(1), 99–111. https://doi.org/10.20473/jcmphr.v5i1.50098
  18. Yusuf, Z. U., Isaac Dibal, N., & Chiroma, M. S. (2023). Iron deficiency in pregnancy: A brief review. Journal of Medical Science, 92(2), e776. https://doi.org/10.20883/medical.e776

Open Access Copyright (c) 2025 Salmah Arafah, Dewiyanti, Ernawati, Dina Oktaviana, Kamriana, Alwi, Zainuddin, Nur Hijrah Syaharani
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AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
Soekarno-Hatta Street, No. 168. Health Polytechnic of Aceh, Aceh Besar, 23352. Telp/Fax: 0651 46126 / 0651 46121.
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