Women considering becoming pregnant or who are within the early weeks of pregnancy, need to ensure that they have enough iron-rich food to prevent anaemia. For, early anaemic pregnant stage may leave their offspring afflicted with intellectually disability (ID), autism spectrum disability (ASD) or attention deficit hyperactivity disorder (ADHD), according to a study published in international journal, JAMA (Journal of the American Medical Association ) Psychiatry.
However, women diagnosed with anaemia later in pregnancy did not have the same risk, said the study which holds importance in the context of India too which is home to 50 per cent anemic pregnant women. Iron is a mineral that plays a key role in the making of red blood cells, which carry oxygen.
The Indian Government has mandated consumption of iron-folic acid tablets for 100 days during pregnancy, but only 30 per cent, or three in every ten, pregnant Indian women consume iron-folic acid (IFA) tablets for at least 100 days (NFHS-4), as per the latest Government survey. Anemia in pregnancy is defined as a hemoglobin concentration of less than 110 g/L (less than 11 g/dL) in venous blood.
The large population-based study (nearly 300,000 mothers of more than 500,000 children born in Sweden between 1987 and 2010) published in the JAMA journal showed that the risk of ASD and ADHD in children whose mothers had anaemia in early pregnancy was 44 per cent and 37 per cent higher, respectively, compared with those children born to mothers without early prenatal anemia.
The risk of intellectual disability was highest, at 120 per cent. However, interestingly, said researchers, anaemia diagnosed after the 30 weeks’ gestation was not associated with an increased risk for any of the neurological development issues. It is believed iron may play an important role in the development of a foetuses’ brain, particularly in a ‘critical window’ before 30 weeks, the scientists said.
“It is part of standard antenatal care to screen pregnant women for low hemoglobin levels, and this is important to continue,” senior author of the study Renee Gardner, PhD, of Karolinska Institute, Stockholm, Sweden, said.
Among the women, 5.8 per cent were diagnosed with anaemia during pregnancy; of these diagnoses, 5 per cent occurred before 30 weeks’ gestation, while 90.9 per cent occurred after 30 weeks’ gestation. However, experts caution that while prenatal iron supplements might offset the risk of conditions associated with anemia, too much iron intake can be toxic.
In India, the prevalence of anaemia in pregnancy is among the highest in the world. The study published in the JAMA journal may not be directly linked with India’s status on number of intellectually/neurological disabled children but definitely indicate the reason that why nearly 1 in 8 children in our country has at least one neurodevelopmental condition.
The actual number may be higher, given that families do not report the cases in view of stigma associated with the condition. The Indian Government has launched Anemia Mukt Bharat (AMB) Strategy under POSHAN Abhiyaan with the aim to reduce anemia prevalence by three percentage points every year till 2022.
Ajay Khera, Deputy Commissioner for Child Health and Immunisation under the Union Health Ministry said that the most important of these is making available the IFA supplementation across the states. While earlier programmes existed for 30 years, the reduction of anaemia has been just 1 percentage point per year, because the coverage of the supplements was about 20 per cent, he said.