title: Effects of anemia at different stages of gestation on infant outcomes.
abstract: OBJECTIVE
  Maternal anemia is a public health challenge worldwide. The present study aims to explore the effects of maternal anemia at different stages of gestation on postnatal growth and neurobehavioral development in infants.
  
  
  METHODS
  A cohort of pregnant Indian women were followed from 13 to 22 wk gestation (i.e., second trimester; n = 211), 29 to 42 wk gestation (i.e., third trimester; n = 178); their infants were followed to ∼3 wk (n = 147) postpartum. Data collected included information on sociodemographic and health-related factors, including anemia (i.e., low hemoglobin status), maternal and infant anthropometric data, and infant neurobehavioral data. A mixed logistic regression model was used to examine the impact of anemia during pregnancy on maternal and infant outcomes (i.e., anthropometric growth parameters and infant neurobehavioral development).
  
  
  RESULTS
  The prevalence of maternal anemia was 41% and 55% (P < 0.001), and iron deficiency anemia was 3.6% and 5.6%, respectively, in the second trimester and third trimester. Infants of pregnant women who were not anemic in the second trimester were 0.26 standard deviations (SD) heavier (P = 0.029), 0.50 SD taller (P = 0.001), and had 0.26 SD larger head circumference (P = 0.029) compared with infants of anemic pregnant women. Infants of pregnant women who were not anemic in the third trimester had orientation scores 3.88 higher (P = 0.004) than infants of women who were anemic.
  
  
  CONCLUSIONS
  Our findings indicate that maternal anemia in the second trimester of gestation influences postnatal infant growth and underscores the necessity of alleviating anemia in young women in the early stages of gestation.
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin, New Zealand. Electronic address: kavitha.menon@otago.co.nz.
authors.forename: Kavitha C
authors.initials: KC
authors.lastname: Menon
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Ferguson
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
authors.forename: Christine D
authors.initials: CD
authors.lastname: Thomson
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Gray
authors.affiliation: Public Health Foundation of India, New Delhi, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Zodpey
authors.affiliation: Symbiosis School of Biomedical Sciences, Symbiosis International University, Pune, India.
authors.forename: Abhay
authors.initials: A
authors.lastname: Saraf
authors.affiliation: Lata Medical Research Foundation, Nagpur, India.
authors.forename: Prabir Kumar
authors.initials: PK
authors.lastname: Das
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Skeaff
mesh_terms: D000328:Adult; D000740:Anemia / Q000150:complications* / Q000453:epidemiology; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000453:epidemiology; D002657:Child Development; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000209:etiology; D019587:Dietary Supplements; D005260:Female; D005865:Gestational Age; D006128:Growth; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D000090463:Iron Deficiencies; D016015:Logistic Models; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D055815:Young Adult
keywords: Anemia; India; Infant outcomes; Iron deficiency; Non-iron deficiency anemia; Pregnant women