Abstract
ObjectivesThe aim of this study was to examine the effects of antenatal exposure to iron deficiency anemia (IDA) and common mental disorders (CMD) on cognitive development of 6 months old infants in a developing country.MethodsA prospective population-based study in a rural province in Vietnam, which enrolled pregnant women at 12–20 weeks gestation and followed them up with their infants until six months postpartum. Criteria for IDA were Hb <11 g/dL and serum ferritin <15 ng/mL. CMD symptoms were assessed by the Edinburgh Postnatal Depression Scale-Vietnam validation. Infant cognitive development was assessed by Bayley Scales of Infant and Toddler Development, 3rd Ed. Path analyses were performed to determine the direct and indirect, partly or fully mediated, causal effects of the antenatal exposures.ResultsA total of 497 pregnant women were recruited, of those 378 women provided complete data which were included in the analyses. Statistically significant direct adverse effects of persistent antenatal IDA (estimated difference of −11.62 points; 95% CI −23.01 to −0.22) and antenatal CMD (−4.80 points; 95% CI: −9.40 to −0.20) on infant Bayley cognitive scores at six months were found. Higher birthweight, household wealth, and self-rated sufficient supply of breastmilk were associated with higher cognitive scores. Maternal age >30 years and primiparity had an indirect adverse effect on infants’ Bayley cognitive scores.ConclusionsThese findings suggest that antenatal IDA and CMD both have adverse effects on child cognitive development, which if unrecognized and unaddressed are likely to be lasting. It is crucial that both these risks are considered by policy makers, clinicians, and researchers seeking to improve child cognitive function in developing countries.
Highlights
It is estimated that 200 million children aged less than 5 years in the world do not reach their developmental potential and most of them are living in low- and lower-middle-income countries [1]
Our study provides evidence that maternal iron deficiency during pregnancy relates to lower infant cognitive development, through both direct and indirect potential pathways
Point prevalence of anemia of 53% had been reported in one prior study in rural Vietnam, there were no existing data about persistent anemia/iron deficiency anemia (IDA) on which to base our estimates, which were higher than were found in this study [47]
Summary
It is estimated that 200 million children aged less than 5 years in the world do not reach their developmental potential and most of them are living in low- and lower-middle-income countries [1]. Several longitudinal studies in humans have concluded that foetal or neonatal IDA is associated with behavioral difficulties in infants and children. These include diminished general autonomic response, motor maturity and self-regulation [7], higher levels of negative emotionality and lower levels of alertness and soothability in infants [8], slower neuronal conduction [9], worse learning ability and memory at 3 to 4 years [10], and poorer performance on mental and psychomotor evaluations at preschool age [11]. All of the human studies were conducted in well-nourished populations in highincome countries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
