Association of dietary patterns with hemoglobin levels among pregnant women in Asahan Regency
Anemia during pregnancy is a serious public health issue that can adversely affect both mothers and fetuses. Dietary patterns play a crucial role in determining the hemoglobin levels in pregnant women. In Indonesia, anemia among pregnant women remains highly prevalent, affecting approximately 48.9% of them. This study aimed to analyze the association between dietary patterns and hemoglobin levels in pregnant women. This study employed a cross-sectional design with a purposive sampling technique, involving 170 pregnant women in Asahan Regency from April to May 2025. Dietary data were collected using a semi-quantitative food frequency questionnaire (SQ-FFQ), and hemoglobin levels were measured using a hematology analyzer. Multivariate regression analysis was performed to examine the association between each dietary pattern and the hemoglobin level. Dietary patterns high in both animal and plant protein were significantly associated with increased hemoglobin levels in pregnant women (95% CI: 12.02–12.7; p<0.001). Conversely, consumption of diets high in sugar and fat was significantly associated with decreased hemoglobin levels (95% CI: 11–11.8; p<0.001). In conclusion, diets rich in animal and plant proteins are positively associated with higher hemoglobin levels in pregnant women. These findings highlight the importance of protein-based nutritional interventions in preventing anemia during pregnancy.
Keywords : Anemia, dietary pattern, hemoglobin levels, pregnant women, principal component analysis
- Abioye, A. I., Okuneye, T. A., Odesanya, A. O., Adisa, O., Soipe, A. I., Ismail, K. A., Yang, J. F., & Fasehun, L. (2021). Calcium intake and iron status in human studies: A systematic review and dose-response meta-analysis of randomized trials and crossover studies. Journal of Nutrition, 151(5), 1084–1101. https://doi.org/10.1093/jn/nxaa437
- 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
- Callister, A., & Aguilar-Alvarez, D. (2021). Effects of indigenous diet iron content and location on hemoglobin levels of Ghanaians. Current Developments in Nutrition, 5(2), 630. https://doi.org/10.1093/cdn/nzab045_012
- Chillo, S. L., Woldesemayat, E. M., & Dangisso, M. H. (2025). Do dietary habits and iron-folic acid intake make a difference? Factors associated with anemia in pregnancy: A multi-center cross-sectional study. Frontiers in Global Women’s Health, 6, 1599842. https://doi.org/10.3389/fgwh.2025.1599842
- Correnti, M., Gammella, E., Cairo, G., & Recalcati, S. (2024). Iron absorption: Molecular and pathophysiological aspects. Metabolites, 14(4). https://doi.org/10.3390/metabo14040228
- Das, A., Bai, C. H., Chang, J. S., Huang, Y. L., Wang, F. F., Chen, Y. C., & Chao, J. C. J. (2023). Associations of dietary patterns and vitamin D levels with iron status in pregnant women: A cross-sectional study in Taiwan. Nutrients, 15(8), 1–16. https://doi.org/10.3390/nu15081805
- Fera, D., Duana, M., & Putri, E. S. (2021). The relationship between adequacy of animal protein consumption and hemoglobin levels for pregnant women. Journal of Nutrition Science, 2(1), 1. https://doi.org/10.35308/jns.v2i2.3361
- Gibore, N. S., Ngowi, A. F., Munyogwa, M. J., & Ali, M. M. (2021). Maternal and pediatric nutrition dietary habits associated with anemia in pregnant women attending antenatal care services. Maternal and Pediatric Nutrition, 5(10), 1–8. https://doi.org/10.1093/cdn/nzaa178
- Hayashi, I., Sakane, N., Suganuma, A., & Nagai, N. (2023). Association of a pro-inflammatory diet and gestational diabetes mellitus with maternal anemia and hemoglobin levels during pregnancy: A prospective observational case-control study. Nutrition Research, 115, 38–46. https://doi.org/10.1016/j.nutres.2023.05.003
- Mayasari, N. R., Bai, C. H., Chao, J. C. J., Chen, Y. C., Huang, Y. L., Wang, F. F., Wiratama, B. S., & Chang, J. S. (2023). Relationships between dietary patterns and erythropoiesis-associated micronutrient deficiencies (iron, folate, and vitamin B12) among pregnant women in Taiwan. Nutrients, 15(10). https://doi.org/10.3390/nu15102311
- Morales Suárez-Varela, M., Peraita-Costa, I., Marín, A. P., Marcos Puig, B., Llopis-Morales, A., & Soriano, J. M. (2023). Mediterranean dietary pattern and cardiovascular risk in pregnant women. Life, 13(1), 1–19. https://doi.org/10.3390/life13010241
- Purnamasari, S. D., Hsu, C., Chen, Y., Kurniawan, A. L., Lee, H., & Chao, J. C. (2022). Combined low plant and high animal dietary pattern is associated with a lower risk of anemia among dyslipidemic adult women in Taiwan: A retrospective study from 2001 to 2015. International Journal of Environmental Research and Public Health, 19(10), 30–39. https://doi.org/10.3390/ijerph19106231
- Purwaningtyas, M. L., & Prameswari, G. N. (2024). Faktor risiko kejadian anemia pada ibu hamil. HIGEIA (Journal of Public Health Research and Development), 8(1), 22–30. https://doi.org/10.15294/higeia.v8i1.65548
- Queiroz, J. C. de L. S., Rey, L. C., Ataide, T. da R., Florêncio, T. M. de M. T., & Silva-Neto, L. G. R. (2025). Consumption of ultra-processed foods is associated with dietary iron availability, anemia, and excess weight in socially vulnerable children. Clinical Nutrition ESPEN, 65, 461–468. https://doi.org/10.1016/j.clnesp.2024.12.023
- Salatas, C., Bronnert, A., Lawrence, R., Alexander, T., Wall, C., Bloomfield, F. H., & Lin, L. (2025). Dietary patterns and diet quality before and/or during pregnancy and how these affect birth outcomes: A systematic review & meta-analysis. Advances in Nutrition, 16. https://doi.org/10.1016/j.advnut.2025.100490
- Shah, T., Khaskheli, M. S., Ansari, S., Lakhan, H., Shaikh, F., Zardari, A. A., Warsi, J., Rind, N. A., Rind, K. H., & Shar, A. H. (2022). Gestational anemia and its effects on neonatal outcome, in the population of Hyderabad, Sindh, Pakistan. Saudi Journal of Biological Sciences, 29(1), 83–87. https://doi.org/10.1016/j.sjbs.2021.08.053
- Sulaiman, N., Givens, D. I., & Anitha, S. (2021). A narrative review: In-vitro methods for assessing bio-accessibility/bioavailability of iron in plant-based foods. Frontiers in Sustainable Food Systems, 5. https://doi.org/10.3389/fsufs.2021.727533
- Zaugg, J., Lopez, J., Barbara, T., Owen, M., Abigail, R. V., Albrecht, C., & Perri, A. N. S. (2024). Obesogenic diet in pregnancy disrupts placental iron handling and ferroptosis and stress signalling in association with fetal growth alterations. Cellular and Molecular Life Sciences, 81, 151. https://doi.org/10.1007/s00018-024-05192-5
- Zhao, J., Li, Z., Gao, Q., Zhao, H., Chen, S., Huang, L., Wang, W., & Wang, T. (2021). A review of statistical methods for dietary pattern analysis. Nutrition Journal, 20(1), 1–18. https://doi.org/10.1186/s12937-021-00692-7
- Zulfiqar, H., Shah, I. U., Sheas, M. N., Ahmed, Z., Ejaz, U., Ullah, I., Saleem, S., Imran, M., Hameed, M., & Akbar, B. (2021). Dietary association of iron deficiency anemia and related pregnancy outcomes. Food Science and Nutrition, 9(8), 4127–4133. https://doi.org/10.1002/fsn3.2373
Copyright (c) 2026 Tika Andriani, Fitriyono Ayustaningwarno, Ahmad Syauqy

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.