September 30, 2019
Anemia early in pregnancy is tied to a greater risk of attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, and intellectual disabilities in children, according to a recent study published in JAMA Psychiatry1 that emphasizes the importance of early iron screenings and nutritional counseling for expectant mothers.
Anemia, characterized by iron deficiency, impacts up to 25 percent of women during pregnancy because the body requires roughly twice the normal amount of iron — about 27 mg per day — during pregnancy. What’s more, iron is known to play a critical role in neurodevelopment; the body uses iron to make hemoglobin, the element in red blood cells that delivers oxygen to both mother and child. “Children with neonatal anemia experience cognitive and behavioral deficits, whereas previous animal studies indicate irreversible neurologic effects of prenatal iron deficiency,” the report reads.
For this study, researchers looked at the relationship between anemia — and the timing of its diagnosis in expectant mothers — and the neurodevelopment of children. They statistically analyzed health data from about 532,000 Swedish youth born between 1987 and 2010, and their roughly 300,000 mothers.
Overall, 5.8 percent of mothers from the group were diagnosed with anemia during pregnancy, with 5 percent diagnosed before the 30-week mark. The researchers found this mark to be significant, as an anemia diagnosis by this point correlated with an increased risk of their children developing the listed neurodevelopmental disorders compared to those born to healthy mothers. The data showed that 9.3 percent of children in the early maternal anemia group were diagnosed with ADHD compared to 7.1 percent in the anemia-free group. Researchers also found that just under 5 percent of children from the maternal anemia group were diagnosed with autism spectrum disorder, compared to 3.5 percent of children from the other group. In addition, 3.1 percent of children in the anemia group were diagnosed with intellectual disabilities, compared to 1.3 percent of children in the larger group. The analysis accounted for socioeconomic, maternal, and pregnancy-related factors.
A maternal anemia diagnosis after the 30-week period, the researchers wrote, “greatly diminished” the chances of a child developing the disorders.
“Our results would support a potentially protective role of iron supplementation in pregnant women with regard to offspring risk of neurodevelopment disorders because iron supplementation can prevent iron deficiency anemia,” part of the study reads.
The researchers noted that part of the study’s strength rested in its data pool, where the subjects came “from a setting with universal access to comprehensive health care.” Among the studies limitations include the lack of information on the timing and effectiveness of treatment administered to women in the group.
1 Wiegersma AM, Dalman C, Lee BK, Karlsson H, Gardner RM. Association of Prenatal Maternal Anemia With Neurodevelopmental Disorders. JAMA Psychiatry. Published online September 18, 2019. doi:10.1001/jamapsychiatry.2019.2309