In the Journals

Maternal anemia in early pregnancy tied to ASD, ADHD in offspring

Maternal anemia in early pregnancy appeared to be linked to greater risk for autism spectrum disorder, ADHD and intellectual disability among offspring, findings published in JAMA Psychiatry revealed.

“Children with neonatal anemia experience cognitive and behavioral deficits, whereas previous animal studies indicate irreversible neurologic effects of prenatal iron deficiency,” Aline Marileen Wiegersma, MS, of the department of public health sciences at Karolinska Institutet in Stockholm, and colleagues wrote. “Studies of maternal supplemental iron and offspring risk [for] neurodevelopmental disorders, such as autism spectrum disorder, have been mixed.”

In this cohort study, researchers examined whether anemia diagnosed in mothers during

pregnancy affected the risk for ASD, ADHD and intellectual disability (ID) in offspring and whether this risk varied depending on the gestational timing of anemia diagnosis during pregnancy. Using health and population register data from the Stockholm Youth Cohort, they assessed 532,232 Swedish children (51.3% male) to determine registered neurodevelopmental diagnoses. The analysis also included nearly 300,000 mothers.

Results showed a higher prevalence of autism, ADHD, and intellectual disability among offspring born to mothers diagnosed with anemia during the first 30 weeks of pregnancy (ASD = 4.9%; ADHD = 9.3%; ID = 3.1%) than among those born to mothers with anemia diagnosed later in pregnancy (ASD = 3.8%; ADHD = 7.2%; ID = 1.1%) or without anemia (ASD = 3.5%; ADHD = 7.1%; ID = 1.3%).

Compared with children born to mothers with anemia later in pregnancy (more than 30 weeks), those born to mothers with anemia diagnosed earlier were more likely to have ASD (OR = 1.44; 95% CI, 1.13-1.84), ADHD (OR = 1.37; 95% CI, 1.14-1.64) and, especially, intellectual disability (OR = 2.2; 95% CI, 1.61-3.01) after adjusting for confounders, according to the researchers.

Wiegersma and colleagues also reported that early anemia diagnosis was similarly linked to risk for ASD (OR = 2.25; 95% CI, 1.24-4.11) and intellectual disability (OR = 2.59; 95% CI, 1.08-6.22) in a matched sibling comparison. In addition, they observed the strongest association between anemia and intellectual disability without co-occurring ASD (OR = 2.72; 95% CI, 1.84-4.01). Furthermore, these associations were not apparent for anemia diagnosed later in pregnancy.

“Given that iron deficiency and anemia are common among women of childbearing age, our findings appear to emphasize the importance of early screening for iron status and nutritional counseling in antenatal care,” the researchers concluded. – by Savannah Demko

Disclosure: Wiegersma reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Maternal anemia in early pregnancy appeared to be linked to greater risk for autism spectrum disorder, ADHD and intellectual disability among offspring, findings published in JAMA Psychiatry revealed.

“Children with neonatal anemia experience cognitive and behavioral deficits, whereas previous animal studies indicate irreversible neurologic effects of prenatal iron deficiency,” Aline Marileen Wiegersma, MS, of the department of public health sciences at Karolinska Institutet in Stockholm, and colleagues wrote. “Studies of maternal supplemental iron and offspring risk [for] neurodevelopmental disorders, such as autism spectrum disorder, have been mixed.”

In this cohort study, researchers examined whether anemia diagnosed in mothers during

pregnancy affected the risk for ASD, ADHD and intellectual disability (ID) in offspring and whether this risk varied depending on the gestational timing of anemia diagnosis during pregnancy. Using health and population register data from the Stockholm Youth Cohort, they assessed 532,232 Swedish children (51.3% male) to determine registered neurodevelopmental diagnoses. The analysis also included nearly 300,000 mothers.

Results showed a higher prevalence of autism, ADHD, and intellectual disability among offspring born to mothers diagnosed with anemia during the first 30 weeks of pregnancy (ASD = 4.9%; ADHD = 9.3%; ID = 3.1%) than among those born to mothers with anemia diagnosed later in pregnancy (ASD = 3.8%; ADHD = 7.2%; ID = 1.1%) or without anemia (ASD = 3.5%; ADHD = 7.1%; ID = 1.3%).

Compared with children born to mothers with anemia later in pregnancy (more than 30 weeks), those born to mothers with anemia diagnosed earlier were more likely to have ASD (OR = 1.44; 95% CI, 1.13-1.84), ADHD (OR = 1.37; 95% CI, 1.14-1.64) and, especially, intellectual disability (OR = 2.2; 95% CI, 1.61-3.01) after adjusting for confounders, according to the researchers.

Wiegersma and colleagues also reported that early anemia diagnosis was similarly linked to risk for ASD (OR = 2.25; 95% CI, 1.24-4.11) and intellectual disability (OR = 2.59; 95% CI, 1.08-6.22) in a matched sibling comparison. In addition, they observed the strongest association between anemia and intellectual disability without co-occurring ASD (OR = 2.72; 95% CI, 1.84-4.01). Furthermore, these associations were not apparent for anemia diagnosed later in pregnancy.

“Given that iron deficiency and anemia are common among women of childbearing age, our findings appear to emphasize the importance of early screening for iron status and nutritional counseling in antenatal care,” the researchers concluded. – by Savannah Demko

Disclosure: Wiegersma reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.