In utero exposure to maternal anaemia linked to neurodevelopmental disorders

  • JAMA Psychiatry

  • International Clinical Digest
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Takeaway

  • Children exposed in utero to maternal anaemia (at 30 weeks of pregnancy) have an increased risk for autism, ADHD, and especially intellectual disability, based on results of this Swedish cohort study.
  • Links were not seen for anaemia later in pregnancy.

Why this matters

  • For children having a workup for developmental conditions, this maternal history could be a factor.  

Key results

  • Prevalences were higher with exposure to maternal anaemia at 30 weeks of pregnancy vs without this exposure:
    • Autism: 4.9% vs 3.8%;
      • aOR, 1.44 (95% CI, 1.13-1.84).
    • ADHD: 9.3% vs 7.2%; 
      • aOR, 1.37 (95% CI, 1.14-1.64).
    • Intellectual disability: 3.1% vs 1.1%;
      • aOR, 2.20 (95% CI, 1.61-3.01).
  • A matched sibling comparison showed similar associations.
  • Anaemia at 30 weeks was also associated with preterm birth risk and being small for gestational age, which in term have been associated with these neurodevelopmental conditions.

Study design

  • Swedish cohort study; 532,232 children (51.3% male) born January 1987-December 2010 to 299,768 mothers.
  • Funding: Swedish Research Council; others.

Limitations

  • The usual limitations of registry data.
  • Limited ascertainment of infections, which are factors in autism risk. 
  • Cause of anaemia was not confirmed.