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Updated: Jun 20, 2026

A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Associations between maternal and child anemia and development outcomes: evidence from a large cross-sectional
Hermano Alexandre Lima Rocha1, Sabrina Gabriele Maia Oliveira Rocha2, Marcia Maria Tavares Machado2
1Community Health Department, Federal University of Ceará, Rua Papi Júnior, 1223, 5th. Floor, Fortaleza, CE, 60430-235, Brazil. hermano@ufc.br.
Insights
Child anemia severity impacts development. Mild anemia is linked to fine motor delays, while moderate-to-severe anemia is associated with gross motor delays, especially in older children. Targeted interventions are crucial.
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Nutritional Anemia
Background:
- Maternal and child anemia are global health concerns.
- Anemia's impact on child development requires further investigation, particularly concerning severity and age-specific effects.
Purpose of the Study:
- To investigate the association between maternal and child anemia and child development up to 72 months.
- To explore the influence of anemia severity and age on specific developmental domains.
Main Methods:
- Cross-sectional study of 2,473 children in Ceará, Brazil.
- Hemoglobin measured using HemoCue Hb 201.
- Child development assessed using Ages and Stages Questionnaires-Brazil (ASQ-BR).
Main Results:
- Overall child anemia was not associated with developmental delays or continuous domain z-scores.
- Mild child anemia correlated with increased fine motor delay.
- Moderate-to-severe child anemia correlated with increased gross motor delay.
- In older children (49-72 months), anemia severity was linked to lower scores in gross motor, fine motor, and problem-solving domains.
Conclusions:
- Anemia severity and timing are critical factors in child development outcomes.
- Findings highlight the need for targeted interventions for anemic children based on severity and age.
- Early detection and management of anemia are essential for optimal child development.
Abstract:
This cross-sectional study investigated the association between maternal and child anemia and development in 2,473 children up to 72 months old in Ceará, Brazil. Hemoglobin was measured using HemoCue Hb 201, and child development was assessed via the Ages and Stages Questionnaires-Brazil (ASQ-BR). In multivariate analyses, neither maternal anemia nor child anemia (overall) was associated with continuous domain z-scores or developmental delays (all p > 0.05). However, when stratified by severity, mild child anemia was associated with a higher prevalence of fine motor delay (Prevalence Ratio = 1.65, 95% CI: 1.18-2.31), while moderate-to-severe child anemia was associated with a higher prevalence of gross motor delay (PR = 1.71, 95% CI: 1.06-2.75). Exploratory analyses revealed effect modification by age; in children aged 49-72 months, mild child anemia was associated with lower gross motor (Standardized Mean Difference = -0.52), fine motor (SMD = -0.91), and problem-solving scores (SMD = -0.33), while moderate-to-severe child anemia was associated with lower gross motor scores (SMD = -0.83). Our findings suggest that the severity and timing of child anemia are associated with specific developmental outcomes, reinforcing the need for targeted interventions.
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