Variables
thalassemia, anemia
BLOOD DISORDER, ANEMIA, DELETION, THALASSEMIA, ALPHA THALASSEMIA
Women and children were defined as having “any alpha thalassemia” if they had a pathological deletion in the alpha globin locus, or if the MLPA probe Hb Constant Spring was positive. Those with triplicated alpha globin genes were identified but not included in the “any alpha thalassemia” group as this condition alone does not manifest in poor hematological outcomes [Structural hemoglobin variants were detected via HPLC and identified by Sanger sequencing of the beta globin gene (HBB). Possible structural variants of the alpha globin genes were not identified by DNA sequencing. Individuals were classified as having “any inherited blood disorder” if either a thalassemia or structural hemoglobin variant was detected. This was the case if HPLC analysis revealed any variation in hemoglobin structure, if common mutations were identified in the beta globin gene through Sanger sequencing, or if any abnormality, excluding triplication, was found on the alpha globin gene, as detected by MLPA.For anemia categorizations, we used the WHO recommended cut-offs for each population group (non-pregnant women: < 12 g/dL; pregnant women: < 11 g/dL for the first and third trimester, < 10.5 g/dL for the second trimester; children 6–37 months: < 11 g/dL) [