Maternal Anemia Alters Structural Development of Child’s Brain

Globally, approximately 273 million people have anemia, with women and children most likely to be afflicted. Roughly 38% of pregnant women and 43% of children are anemic. During pregnancy, anemia is associated with worse maternal and infant health, maternal mortality, stillbirth, prematurity, and low birth weight. In an article in JAMA Network Open, researchers set out to determine how anemia can impact brain volumes in early childhood, finding that maternal anemia alters the structural development of the child’s brain.

Researchers in this study gathered information from 147 mother–child pairs in South Africa. Pediatric brain volume was analyzed using a high-resolution T1-weighted MRI, looking at global, subcortical, and corpus callosum volumes.

In this study, anemia was characterized by hemoglobin less than 11 g/dl. In the observed cohort, the prevalence of maternal anemia was approximately 31.3%.

According to the researchers, the MRIs showed maternal anemia was associated with smaller putamen, corpus callosum, and bilateral caudate volumes. The caudate of children born by those with maternal anemia was 5.3% smaller than their non-anemic counterparts. The putamen and corpus callosal were also 4.33% and 7.75% smaller, respectively.

In addition to maternal anemia, researchers also looked at child anemia, finding the prevalence to be approximately 52.5%. Unlike maternal anemia, child anemia was not associated with significant differences in brain volume. Additionally, researchers found no significant correlation between maternal anemia and the probability of child anemia.

The investigators postulate that hemoglobin-facilitated delivery and oxygen consumption in the brain may be reduced by anemia; however, the mechanisms explaining why anemia may alter the child’s brain structure development are poorly understood.

Researchers in the publication concluded, “the findings of this neuroimaging nested cohort study support the global recognition of anemia in pregnancy as a health priority. Maternal anemia, but not child anemia, was associated with smaller basal ganglia volumes and reduced corpus callosum size in children aged 2–3 years. Therefore, antenatal maternal anemia, even when in the mild range, may have persistent consequences for the developing brain. This finding emphasizes the fetal origins of brain health, highlighting the need to implement effective interventions targeting prevention and treatment of maternal anemia for improved child outcomes.”