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Association of Anemia with Neurodevelopmental Disorders in a Nationally Representative Sample of US Children
Wenhan Yang1, Buyun Liu2, Rui Gao3
1Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA; Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Insights
Anemia is linked to higher rates of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and learning disability in US children. Further research is needed to understand the connection between anemia and these neurodevelopmental disorders.
Area of Science:
- Pediatric Health
- Neurodevelopmental Disorders
- Hematology
Background:
- Anemia is a common condition in children, potentially impacting cognitive and developmental outcomes.
- Neurodevelopmental disorders such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and learning disability present significant challenges in childhood.
- Understanding the relationship between anemia and these disorders is crucial for early identification and intervention.
Purpose of the Study:
- To investigate the association between anemia and the prevalence of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and learning disability in a large, nationally representative sample of US children.
- To determine if children with anemia have a higher likelihood of being diagnosed with these neurodevelopmental disorders.
Main Methods:
- Utilized data from the National Health Interview Survey (NHIS) spanning 1997-2018, including children aged 3-17 years.
- Employed parent/guardian-reported physician diagnoses of anemia, ASD, ADHD, and learning disability.
- Applied multiple logistic regression analysis with sample weights to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Main Results:
- The study included 213,893 children; 1.06% had anemia.
- Children with anemia showed significantly higher odds of having ASD (aOR=2.07), ADHD (aOR=1.84), and learning disability (aOR=2.22) compared to children without anemia.
- Prevalence of ASD was 1.94% in anemic children vs. 1.07% in non-anemic children; ADHD was 12.24% vs. 7.73%; learning disability was 15.03% vs. 7.75%.
Conclusions:
- Significant associations were found between anemia and increased likelihood of ASD, ADHD, and learning disability in US children.
- These findings highlight a potential link between iron deficiency and neurodevelopmental outcomes.
- Further research is recommended to explore causality and underlying biological mechanisms connecting anemia and neurodevelopmental disorders.
Objective:
To examine the associations of anemia with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and learning disability in US children.
Study Design:
We included children and adolescents aged 3-17 years from the National Health Interview Survey (NHIS), 1997-2018. Information about physician-diagnosed history of anemia, ASD, ADHD, and learning disability was reported by a parent or guardian. Multiple logistic regression with sample weights was used to estimate the ORs and 95% CIs of neurodevelopmental disorders according to the presence of anemia.
Results:
Of the total population of 213 893 children aged 3-17 years (mean age [SE], 10.01 [0.01] years), 2379 were reported to have a diagnosis of anemia, for a weighted prevalence of 1.06% (95% CI, 1.01-1.12). The prevalence of ASD was 1.94% (95% CI, 1.20-2.68) among children with anemia and 1.07% (95% CI, 1.01-1.14) among those without anemia. The corresponding prevalences were 12.24% (95% CI, 10.47-14.00) and 7.73% (95% CI, 7.58-7.88) for ADHD and 15.03% (95% CI, 13.08-16.99) and 7.75% (95% CI, 7.39-7.70) for learning disability, respectively. Compared with those without anemia, children with anemia were more likely to have neurodevelopmental disorders, with an aOR of 2.07 (95% CI, 1.39-3.08) for ASD, 1.84 (95% CI, 1.55-2.19) for ADHD, and 2.22 (95% CI, 1.90-2.60) for learning disability.
Conclusions:
In a nationally representative sample of US children, we found significant associations between anemia and neurodevelopmental disorders including ASD, ADHD, and learning disability. Further investigation is warranted to assess the causality and elucidate the underlying mechanisms.
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