1. Anemia during pregnancy associated with altered brain structure in children including smaller volumes of bilateral caudate, putamen and corpus callosum
Evidence Rating Level: 2 (Good)
It is estimated that 38% of pregnant women worldwide are anemic. Anemia is known to be a risk factor for poor maternal and infant health outcomes, however limited studies have been done to determine the association of maternal anemia with child brain structure. This cohort study sought to further investigate this association by examining the subsequent brain structure changes of 147 mother child pairs. Mothers had hemoglobin levels measured during pregnancy and these levels were adjusted for trimester of pregnancy. Children had brain magnetic imaging done at age 2-3 years, hemoglobin was only measured in children if they had hospital visits between birth and MRI. Of the 147 mothers, 31% were found to have anemia in pregnancy. After adjusting for covariates, maternal anemia was not found to be associated with child global brain volumes but significant associations between individual structures were identified including: smaller volumes of bilateral caudate, putamen and corpus callosum (−5.30% [95% CI, −7.01 to −3.59, −4.33% [95% CI, −5.74 to −2.92], −7.75% [95% CI, −11.24 to −4.26] respectively). Not all of the children in the study had hemoglobin measurements taken, however within those who did child anemia was not found to be associated with brain volume changes. Limitations to this study include a high-risk group as many participants had maternal HIV and alcohol use, as well as a small sample size for child anemia. Additionally, this study did not include any longitudinal findings, limiting the ability of the study to further extrapolate subsequent neurodevelopmental outcomes. Overall, this study shows that maternal anemia has an association with brain development in children, and optimizing interventions to manage maternal anemia may have a positive impact on brain development.
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