Association of Maternal Preconception Hemoglobin Concentrations with Child Health and Development From Birth Through 6 y

OBJECTIVES: The long-term impact of maternal nutritional status before pregnancy on child health and development (CHD) is unclear. We examined associations between maternal preconception hemoglobin (Hb) concentrations and anemia with CHD from birth through 6 y. CHD outcomes included: a) birth outcomes (birth weight, birth length, preterm, gestational age, or small for gestational age) b) child Hb at 3 mo, 1 y, and 2 y c) motor and mental development at 1 y and 2 y (Bayley scales for infant development) and cognitive functioning at age 6 y (Wechsler Intelligence Scale for Children). METHODS: We used data from a randomized controlled trial (PRECONCEPT) that was conducted in Vietnam. Over 5000 women of reproductive age who were intending to get pregnant were recruited of whom birth outcome data were obtained prospectively for 1599 mother-infant pairs who were followed through age 6 y (n = 1266). Multivariable linear regressions and logistic regression were used to assess the association between preconception Hb on CHD outcomes and adjusted for confounding variables at the maternal, child and household levels. RESULTS: At preconception enrollment, 20% of the women were anemic. Neither preconception anemia or maternal Hb was significantly associated with birth outcomes. Maternal preconception Hb was positively associated with child Hb at 3 mo (0.06; 95% CI: 0.01,0.11), 6 mo (0.08;; 95% CI: 0.03,0.13) and 12 mo (0.10;; 95% CI: 0.05–0.15) but not 24 mo. Likewise, maternal preconception Hb was associated with a reduced risk of child anemia at 6 mo (0.90; 95% CI: 0.82–0.98) and 12 mo (0.84; 95% CI: 0.77–0.92). Maternal preconception Hb was also positively associated with child motor development at 12 months (0.26; 95% CI: 0.06,0.47) but not with child cognition and language. At 6–7 years, maternal preconception Hb was not significantly associated with child development. CONCLUSIONS: Maternal preconception Hb is associated with child hemoglobin concentrations across the first year of life. However, in this cohort from Vietnam, preconception Hb was not a significant predictor of birth outcomes or long-term child development. FUNDING SOURCES: NIH (1R03HD102513-01), Nestle Foundation, Micronutrient Initiative, Mathile Institute for Advancement of Human Nutrition.