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Maternal anemia and offspring failure to thrive - results from a large population-based cohort
Omer Kaplan1, Tamar Wainstock2, Eyal Sheiner3
1Faculty of Health Sciences, Goldman Medical School, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Insights
Maternal anemia, a condition where mothers have low hemoglobin levels, is linked to increased risk of failure to thrive (FTT) in children. The severity of maternal anemia correlates with higher rates of FTT in offspring.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Public Health
Background:
- Maternal anemia, characterized by low hemoglobin (Hb) levels, is a significant global health concern.
- The potential long-term impact of maternal anemia on offspring development, specifically failure to thrive (FTT), requires further investigation.
Purpose of the Study:
- To determine if there is an association between maternal anemia and the development of failure to thrive (FTT) in children.
- To assess the relationship between the severity of maternal anemia and the risk of offspring FTT.
Main Methods:
- A population-based cohort study analyzed data from singletons born between 1991 and 2014.
- Maternal hemoglobin levels were categorized postpartum: <9.0 g/dL (moderate-severe anemia), 9.0-11.0 g/dL (mild anemia), and ≥11.0 g/dL (no anemia).
- Survival analysis (Weibull model) was used to evaluate the independent association between maternal anemia and offspring FTT, controlling for confounders.
Main Results:
- The study included 214,305 deliveries; 10.3% of mothers had moderate-severe anemia and 39.2% had mild anemia.
- Failure to thrive (FTT) rates were 1.3% in the moderate-severe anemia group, 1.2% in the mild anemia group, and 1.1% in the no anemia group (p=.003).
- Moderate-severe maternal anemia showed a significantly higher cumulative incidence of FTT (p<.001). Both mild and moderate-severe maternal anemia were independently associated with FTT hospitalizations (aHRs 1.1 and 1.321, respectively).
Conclusions:
- Maternal anemia is independently associated with an increased risk of failure to thrive (FTT) in offspring.
- The risk of FTT in children increases proportionally with the severity of maternal anemia.
Objective:
To evaluate whether an association exists between maternal anemia and offspring failure to thrive (FTT) during childhood.
Methods:
A population-based cohort analysis was performed, comparing the risk for FTT among children (up to 18 years old) based on maternal hemoglobin (Hb) levels, upon postpartum discharge. Maternal Hb levels were categorized into 3 levels: <9.0 (moderate-severe anemia), 9.0-11.0 (mild anemia), and ≥11.0 g/dL (no anemia). FTT diagnosis was based on hospital records. All singletons born between 1991 and 2014 and discharged alive without congenital malformations were included. A survival curve was constructed to compare the cumulative FTT incidence, and a Weibull parametric survival analysis to assess the independent association between maternal anemia and offspring FTT while controlling for confounders.
Results:
Of the 214,305 included deliveries, 22,071 parturients (10.3%) were discharged with Hb <9.00; 83,932 (39.2%) with Hb between 9.0-11.0; and 108,302 (50.5%) with Hb ≥11.0 g/dL. FTT rates were 1.3% (n = 287), 1.2% (n = 967), and 1.1% (n = 1141) in the same groups, respectively (p = .003). The survival curve demonstrated a significantly higher cumulative incidence of FTT diagnosis in the moderate-severe maternal anemia group (p < .001). In the Weibull analysis, constructed for newborns with appropriate birthweight, both groups of maternal anemia were found to be independently associated with FTT related hospitalizations (mild anemia aHR, 1.1; 95%CI 1.002-1.219; p = .045, moderate-severe anemia aHR, 1.321; 95%CI, 1.141-1.529; p < .001).
Conclusion:
Maternal anemia is independently associated with long-term FTT in offspring, with increasing FTT rates proportional to anemia severity.
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