Does Maternal Anaemia Affect Foetal Neurodevelopment? Doctor Answers

National Safe Motherhood Day is observed every year on April 11. The day aims to raise awareness about maternal health, healthcare for pregnant women, reducing maternal mortality and ensuring access to safe and respectful delivery services. One of the indicators of maternal mortality is the Maternal Mortality Ratio (MMR). It is the number of maternal deaths during a given time period per 100,000 live births during the same time period. Maternal mortality in India has reduced from 130 per 100,000 live births in 2014-16 to 97 per 100,000 live births in 2018-20. It is a key indicator of healthcare quality and accessibility, reflecting the effectiveness of maternal health services. On May 15, 2015, World Health Organisation (WHO) certified India for eliminating maternal and neonatal tetanus. Maternal mortality trends in India also show a steady decline over the years.

Anaemia during pregnancy has a significant impact on maternal health and foetal development. Anaemia is defined as a decrease in the oxygen carrying capacity of blood, usually due to a decrease in haemoglobin concentration. In pregnancy, it is defined as a haemoglobin of less than 11 gm/dl. Speaking to NDTV, Dr. Sunita Varma, Senior Director & HOD Obstetrics & Gynaecology at Fortis Hospital Shalimar Bagh, said, "There are many causes of anaemia in pregnancy, but in India, the most common is a nutritional deficiency of iron. In our country, the scale of this problem is striking, more so in low socioeconomic strata. This is due to our predominantly vegetarian diet which contains very little absorbable iron and vitamin B12."

Maternal Anaemia In India

According to a National Family Health Survey (2019 - 2021), 52.2% of pregnant women are anaemic; that is, every second pregnancy is affected. In fact, 57% of women enter pregnancy already nutritionally compromised. Worm infestations, short interpregnancy intervals and delayed antenatal care compound the problem.

Maternal Anaemia And Foetal Brain Development

While it has been accepted for some time now that anaemia leads to maternal mortality and morbidity, now it is being viewed as a threat to the child's brain development - even before birth - as well. Maternal anaemia directly affects the oxygen and nutrient supply to the foetus, especially the rapidly developing brain in the second and third trimester.

Iron is essential for myelination (nerve fibre insulation), synthesis of neurotransmitters (chemicals carrying brain signals), and hippocampal development; all processes affecting memory, learning and behaviour. Also, maternal anaemia can cause preterm birth and foetal growth restrictions, which independently increase the likelihood of developmental delays in the child.

Maternal Iron Deficiency And Cognitive Development

Studies have shown that maternal iron deficiency, especially in early pregnancy, is linked to lower cognitive performance, delayed language development and behavioural problems in children. While severe anaemia (Hb < 7 gm/dl) carries a substantial risk, even moderate anaemia (Hb 7 - 10 gm/dl), can have subtle but cumulative effects. One large study in Sweden (Wiegersma et al. 2019) conducted on more than 5,32,000 children showed that maternal anaemia at less than 30-week gestation increased risks of Autism, ADHD and Intellectual Disability. The same study also concluded that the timing of anaemia during pregnancy was a critical factor. The earlier the anaemia, the stronger the neurodevelopmental effects.

Prevention Of Maternal Anaemia

All is not doom and gloom. The promising reality is that maternal anaemia is largely preventable and treatable. Early antenatal care, regular haemoglobin screening, dietary counselling, deworming and timely administration of oral/ intravenous iron therapy can greatly improve outcomes for both mother and child.

The Indian Government has launched large scale public health initiatives like 'anaemia Mukt Bharat Programme', iron-folic acid supplementation and 'POSHAN Abhiyaan'. That said, prevalence still remains high. Even in upper socioeconomic strata, challenges remain with poor oral iron therapy compliance, gastrointestinal side effects and poor screening and follow up.

The fact of the matter is, correcting maternal anaemia is not just about addressing laboratory values but rather protecting and safeguarding the neurodevelopmental potential of the next generation. "India is faced with one of the highest global burdens of anaemia and thus tackling maternal anaemia should be a prime focus in order to improve maternal health and the cognitive capital of our country's future," said Dr. Varma.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.