Association between hormonal contraceptive use and markers of iron status among women in Tanzania

Objective: The relationship between hormonal contraceptive use and iron status is still unclear. The purpose of this study was to examine the association between hormonal contraceptive use and markers of iron status in a population-based sample of Tanzanian women.

Methods: A cross-sectional study was conducted using data from the 2010 Tanzania Demographic and Health Survey. Multivariable logistic regression was used to examine the associations between hormonal contraceptive use and iron deficiency, anemia and iron deficiency anemia, objectively measured using hemoglobin and serum transferrin receptor.

Results: Of the 4186 women included in the study, approximately 19.0% reported history of hormonal contraceptive use. The prevalence of iron deficiency, anemia and iron deficiency anemia were 30.0%, 39.5%, and 14.3%, respectively. History of hormonal contraceptive use was negatively associated with iron deficiency, anemia and iron deficiency anemia, independent of potential confounders. Compared to noncontraceptive users, the multivariable-adjusted odds ratio: OR (95% CI) among hormonal contraceptive users was 0.73 (0.56 - 0.94; p < 0.05) for iron deficiency anemia 0.58 (0.46 - 0.72; p < 0.001) for anemia and 0.53 (0.37 - 0.74; p < 0.001) for iron deficiency anemia. Longer duration (> 2 years of hormonal contraceptive use) was strongly associated with iron deficiency 0.63 (0.43 - 0.91; p for trend <0.05), anemia 0.51 (0.36 - 0.73; p for trend <0.001) and iron deficiency anemia 0.35 (0.19 - 0.65; p for trend <0.001).

Conclusion: Our finding has important implications for educating healthcare providers and women about additional nutritional benefits of using hormonal contraceptives.