Babies born to mothers who experienced anaemia during pregnancy may have smaller brain volumes in early childhood, particularly in areas associated with movement, learning, emotional regulation and other important cognitive functions, according to a new study by researchers from King’s College London and the University of Cape Town. The findings have raised fresh concerns about the potential long-term effects of maternal anaemia and highlighted the importance of preventing and treating the condition during pregnancy.
The study, published in the journal Brain Communications, followed 394 mother-infant pairs in Cape Town and used magnetic resonance imaging (MRI) to examine brain development in babies between three months and two years of age. Researchers found that children whose mothers had been diagnosed with anaemia during pregnancy had, on average, total brain volumes about 4% smaller than those of babies whose mothers had not been anaemic.
The researchers identified differences in several specific regions of the brain, including the putamen, caudate nucleus and corpus callosum. These structures play important roles in a range of neurological and psychological functions, including movement, learning, processing speed, communication between the two halves of the brain, emotional regulation and executive functioning.
Of particular concern to the researchers was that the differences did not appear to disappear as the children grew. Instead, the gap in some areas became wider during the first two years of life. The corpus callosum, for example, was around 4% smaller among babies exposed to maternal anaemia at 12 months, with the difference increasing to about 6% by the age of two. Previous research involving South African toddlers and school-age children had also reported differences in brain volume in some of the same regions.
Jessica Ringshaw, the study’s first author and a researcher at King’s Institute of Psychiatry, Psychology & Neuroscience and the University of Cape Town, said the findings were significant because the observed differences persisted beyond infancy. Earlier research has suggested that children born to mothers with anaemia can perform less well on certain developmental assessments, and the researchers believe the new brain-imaging findings could help explain some of those observations.
Importantly, many of the mothers included in the study had only mild anaemia, suggesting that even relatively modest maternal anaemia may be associated with measurable differences in infant brain development. Anaemia is commonly caused by iron deficiency, although researchers noted that its causes can be more complex and may also include infections and other nutritional or health-related factors.
Anaemia during pregnancy remains a major global health concern. More than one-third of pregnant women worldwide are estimated to experience the condition, with particularly high rates reported in sub-Saharan Africa and South Asia. Symptoms can include tiredness, dizziness and shortness of breath, although some women may have few noticeable symptoms.
The researchers stressed that addressing maternal anaemia should therefore be an important part of antenatal healthcare. Screening women for anaemia and iron deficiency, particularly during pregnancy, could help identify those who require treatment. Depending on the individual’s medical condition, treatment may include oral iron supplements or, in some cases, intravenous iron. Researchers also emphasised that underlying causes such as infections need to be identified and managed alongside nutritional deficiencies.
The study also demonstrated the potential of newer medical technology to make research into infant brain development more accessible. Researchers used portable, ultra-low-field MRI scanners alongside conventional high-field MRI equipment. The portable technology was sensitive enough to detect the brain-volume differences observed in babies exposed to maternal anaemia, potentially opening the door to wider use of neuroimaging in areas where conventional MRI facilities are difficult to access.
Researchers said the findings reinforce the need to treat anaemia not simply as a maternal health issue but also as a potential factor influencing children’s development. However, the study identifies an association between maternal anaemia and differences in infant brain structure and does not by itself establish that anaemia directly causes later cognitive difficulties.
The research team said further work will be needed to determine how these structural differences affect children’s development as they grow older and whether effective prevention and treatment of maternal anaemia can reduce or reverse the observed effects. The findings nevertheless add to growing evidence that maternal nutrition and health during pregnancy can have consequences extending well beyond childbirth, making early screening, adequate nutrition and timely medical care essential components of maternal and child health programmes.
