Child hemoglobin trajectories across the first 10 years of life and association with child cognition and academic achievement at 10-11 years

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dc.creatorYoung, Melissa F.
dc.creatorTran, Lan Mai
dc.creatorNguyen, Phuong Hong
dc.creatorKalam, Md Abul
dc.creatorKhuong, Long Quynh
dc.creatorMartorell, Reynaldo
dc.creatorRamakrishnan, Usha
dc.date2026-05
dc.date2026-03-26T15:38:10Z
dc.date2026-03-26T15:38:10Z
dc.date.accessioned2026-06-27T15:18:52Z
dc.descriptionBackground Anemia is a global health concern, though the importance of changes in hemoglobin (Hb) and cognitive outcomes in childhood remains unclear. Objective We examined the association between child Hb trajectories and anemia with cognitive development and academic achievement at 10-11y. Methods We used prospective data from Vietnamese children (n=831) born to women who participated in a micronutrient supplementation trial (PRECONCEPT). Hb was measured at 3mo, 6mo, 1y, 2y and 10-11y. Multivariable linear regression models assessed the association between Hb trajectories and anemia with cognitive development (full-scale intelligence quotient- FSIQ), and academic achievement (mathematics and reading) at 10-11y, adjusting for maternal (intervention, education, age, mental health), child (age, sex), and household (home environment, socioeconomic status) characteristics. Results Three child Hb trajectories were identified (low-6.4%, middle-52.2% and high-41.4%). Compared to the middle and high trajectory groups, children in the low trajectory had the lowest Hb levels at 3 months (Hb: 9.7g/dL) and through age 10-11y (11.2g/dl). Children in the low-Hb trajectory had lower FSIQ (89.8 vs 93.2), math (12.1 vs 13.5) and reading (17.8 vs 19.0) scores compared to the high-Hb trajectory. These differences were attenuated in adjusted models. Children in the low and middle Hb trajectories had non-significantly lower FSIQ (-0.93; 95% CI: [-4.57, 2.71] and (-1.13 [-2.92, 0.66]), reading scores (-0.01 [-1.36,1.34]) and -0.46 [-1.13,0.21]) and math scores (-0.57 [-1.15,0.01] and -0.65 [-1.82, 0.51]). Anemia status at 10-11y was negatively associated with FSIQ (-3.82 [-6.68, -0.76]) and math scores (-1.04 [-2.03, -0.05]) in adjusted models. Conclusion Child Hb trajectories across the first 10 years of life were largely established early in life and had weak associations with cognition and academic achievement at 10-11y. Anemia among 10-year-old children was associated with lower IQ and math scores, which underscores the importance of continued investment in nutrition programs among school-age children.
dc.identifierhttps://hdl.handle.net/10568/182275
dc.identifier.urihttp://hdl.handle.net/123456789/100863
dc.languageen
dc.publisherElsevier
dc.rightsOpen Access
dc.sourceYoung, Melissa F.; Tran, Lan Mai; Nguyen, Phuong; Kalam, Md Abul; Khuong, Long Quynh; Martorell, Reynaldo; and Ramakrishnan, Usha. 2026. Child hemoglobin trajectories across the first 10 years of life and association with child cognition and academic achievement at 10-11 years. The Journal of Nutrition 156(5): 101491. https://doi.org/10.1016/j.tjnut.2026.101491
dc.subjectchildren
dc.subjectnutrition
dc.subjectanaemia
dc.subjectchild development
dc.subjectanthropometry
dc.subjecteducation
dc.subjecthaemoglobin
dc.titleChild hemoglobin trajectories across the first 10 years of life and association with child cognition and academic achievement at 10-11 years
dc.typeJournal Article

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