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Sex-specific association between maternal mild anemia and children’s behavioral development: a birth cohort study

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Abstract

There has been limited research on maternal anemia affecting children’s behavioral development, with a lack of studies focusing on sex differences in this association. Based on the Ma’anshan Birth Cohort, 2132 mother-child pairs were included. Maternal anemia was evaluated based on the hemoglobin concentration and children’s behavioral development was assessed by Achenbach Child Behavior Checklist 1.5-5. Binary logistic regression models indicated that compared with children born of mothers without anemia throughout pregnancy, maternal mild anemia during pregnancy or only anemia in the 3rd trimester was associated with increased risks of aggressive behaviors in boys. Maternal mild anemia only in the 2nd trimester was associated with increased risks of attention problems in boys. In girls, maternal mild anemia during pregnancy was associated with increased risks of withdrawn, internalizing problems and total problems. Girls born of mothers with mild anemia only in the 2nd trimester had higher risks of total problems. Maternal mild anemia in both 2nd and 3rd trimesters was associated with increased risks of internalizing problems in girls. Our study identified sex-specific effects of maternal mild anemia during pregnancy on children’s behavioral development problems.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all the women and children participated in the birth cohort. We are also grateful for all researchers and medical workers involved in the study at the Ma’anshan Maternal and Child Healthcare Center for their contributions.

Funding

This work was supported by The National Natural Science Foundation of China (82273639); The National Key Research and Development Program of China (2022YFC2702901); Scientific Research Promotion Project of Anhui Medical University (2023xkjT005); Research Fund of Anhui Institute of Translational Medicine (ZHYX2020A001); Scientific Research Platform Base Construction Foundation of Anhui Medical University (2023xkjT053); "Early Scientific Exposure" Training Program of Anhui Medical University (2022-ZQKY-82).

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Authors and Affiliations

  1. Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People’s Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China

    Xuemei Hao, Yufan Guo, Jingru Lu, Linlin Zhu, Fangbiao Tao & Kun Huang

  2. Ma’anshan Maternal and Child Health Center, Ma’anshan, China

    Shuangqin Yan

  3. Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China

    Kun Huang

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  1. Xuemei Hao
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  2. Yufan Guo
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  3. Jingru Lu
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  4. Linlin Zhu
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  5. Shuangqin Yan
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Contributions

F.T. and K.H. conceived and designed the research. X.H. performed the statistical analyses and drafted the manuscript. L.Z., Y.G., J.L. and S.Y. collected data. All authors reviewed the manuscript and approved the final manuscript.

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Correspondence to Kun Huang.

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The authors declare no competing interests.

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Hao, X., Guo, Y., Lu, J. et al. Sex-specific association between maternal mild anemia and children’s behavioral development: a birth cohort study. Eur Child Adolesc Psychiatry (2024). https://doi.org/10.1007/s00787-024-02411-z

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