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Effects of increased hemoglobin on child growth, development, and disease: a systematic review and meta-analysis

Leila Margaret Larson1, Julianne Nicole Kubes2, Maria J Ramírez-Luzuriaga3

  • 1Department of Medicine, the University of Melbourne, Melbourne, Australia.

Annals of the New York Academy of Sciences
|June 4, 2019
PubMed

Insights

This study found that increasing hemoglobin (Hb) levels in young children positively impacts motor and mental development. However, more research is needed to pinpoint specific Hb thresholds for negative functional outcomes.

Area of Science:

  • Pediatric Nutrition
  • Hematology
  • Developmental Pediatrics

Background:

  • The World Health Organization (WHO) recommends a hemoglobin (Hb) cutoff of 11 g/dL for anemia in children under 5.
  • Few studies have validated this cutoff against actual functional consequences.
  • Understanding the full spectrum of Hb's impact on child development is crucial.

Purpose of the Study:

  • To systematically review and meta-analyze studies on the functional consequences of varying hemoglobin concentrations in children under 5.
  • To investigate the relationship between Hb levels and outcomes in growth, development, and chronic disease.
  • To identify potential inflection points where low Hb impacts function.

Main Methods:

  • Systematic review and meta-analysis of iron intervention and observational studies.
  • Inclusion of 56 intervention and 20 observational studies from an initial search of 5049.
  • Metaregression analysis to assess associations between Hb changes and functional outcomes in intervention trials.

Main Results:

  • Iron supplementation trials showed significant positive associations between increased Hb and improved motor (0.28 SD) and mental development (0.24 SD) scores.
  • Stronger associations between Hb improvements and mental development were observed in children with lower baseline Hb.
  • Observational studies had high heterogeneity, preventing pooled analysis of Hb and functional outcomes.

Conclusions:

  • Increased hemoglobin levels are linked to better motor and mental development in young children.
  • The current WHO anemia cutoff may not precisely align with functional consequences across all children.
  • Further research is required to establish specific Hb thresholds and understand influences like inflammation and age on functional outcomes.

Keywords:
growthhemoglobinlanguage developmentmental developmentmotor development

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