Vol.:(0123456789) 1 3 Maternal and Child Health Journal https://doi.org/10.1007/s10995-020-02912-8 Is Anemia in Low Income Pregnant Women Related to Their Infants’ Having Anemia? A Cohort Study of Pregnant Women‑Infant Pairs in the United States Mayri Sagady Leslie 1  · Jeongyoung Park 1  · Linda A. Briggs 1  · Majeda M. El‑Banna 1  · Jessica Greene 2 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Objective Given evidence that anemia in the frst year of life is associated with long-term cognitive, motor, and behavioral defcits, reducing infant anemia is important. The primary objective of this research is to examine whether anemia in low income pregnant women in the United States is associated with anemia in the women’s infants. Methods This cohort study linked Centers for Disease Control and Prevention surveillance data on pregnant women with incomes below 185% of the federal poverty level from 2010 and 2011 with data on 6–11 month olds from 2011, resulting in a sample of 21,246 uniquely matched mother-infant pairs. We examined bivariate and multivariate relationship between anemia severity in pregnant women and in their infants. Results Seventeen percent of women had anemia (13.1% mild and 3.9% moderate to severe) and 20.1% infants had anemia (16.4% mild and 3.7% moderate to severe). For both women and infants, blacks had substantially higher anemia rates than whites. In bivariate analysis and multivariate analyses maternal anemia showed a dose–response relationship to infant anemia. In predicted probabilities from the multivariate models, 27.2% of infants born to pregnant women with moderate to severe anemia had anemia, compared to 23.3% for infants whose mothers had mild anemia, and 18.3% for infants whose mothers did not have anemia. Conclusion This study provides strong evidence of a relationship between maternal and infant anemia in the United States among people with low incomes. Eforts to reduce anemia during pregnancy may be an important strategy for minimizing childhood anemia. Keywords Maternal anemia · Infant anemia · Iron defciency anemia · Racial and ethnic disparities Objectives To improve children’s health, a clearer understanding of the factors related to anemia in the frst year of life is impor- tant. During infancy, iron is essential for fueling energy metabolism and early brain development (Lönnerdal et al. 2015). Iron deficiency (ID) and iron deficiency anemia (IDA) are associated with changes in infants’ brain mye- lination and subsequent defcits in cognitive, motor and behavioral function—even with early identifcation and iron replacement (Erickson-Owens et al. 2018; Geng et al. 2015; Georgief 2017; Lozof et al. 2006,2013; Radlowski and Jhonson 2013). These fndings raise the question of whether anemia in pregnant women is related to their infants having anemia. If so, strategies to prevent anemia in children could focus on women during pregnancy. Most prior research evaluating the relationship between anemia in pregnant women and their children has been con- ducted in middle and low income countries. Anemia preva- lence is high in these countries, 42% and 59% respectively among children under 5 years old, driven by a combination of poor nutrition (low iron rich food), infectious disease, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-020-02912-8) contains supplementary material, which is available to authorized users. * Mayri Sagady Leslie mayri@gwu.edu 1 George Washington University, 1990 Pennsylvania Avenue NW, Suite 500, Washington 20007, D.C., USA 2 Luciano Chair of Health Care Policy, Baruch College, City University of New York, One Bernard Baruch Way, D-901, New York, NY 10010, USA