A study published in the September issue of Pediatrics reports an association between maternal binge drinking and iron-deficiency anemia (IDA) in infants.

The study sample included 96 infants born to mixed race mothers in Cape Town, South Africa. Approximately one-half (42) of the mothers drank heavily during pregnancy (4 or more drinks per episode), and the remaining mothers (54) drank small amounts of alcohol (less than one-half ounce per day) or no alcohol.

Seventy percent of the mothers smoked cigarettes during pregnancy, with one-fifth of the mothers smoking 10 or more cigarettes per day. Women who drank heavily, smoked twice as many cigarettes as those who drank lightly or not at all.

Infants whose mothers drank heavily were 3.6 times more likely to be diagnosed with IDA at 12 months of age compared to infants whose mothers drank lightly or not at all. Among the 54 infants with IDA, cigarette smoking was related to both alcohol use and IDA. Even after the researchers excluded infants born to moderate or heavy smokers, higher rates of IDA persisted among infants whose mothers drank heavily.

The higher incidence of IDA among infants born to mothers who drink heavily may reflect inadequate accumulation of fetal iron stores or inadequate iron intake or absorption postnatally (after birth). Disruption of fetal iron stores could be significant given that infants rely upon prenatally acquired iron for the first 6 months of life before dietary intake plays a more substantial role.

Regardless of the mechanism, the clear association between prenatal alcohol exposure and increased risk of IDA suggests a need for targeted iron-deficiency screening and intervention for fetal alcohol-exposed children. This is particularly important, given the well-documented effects of IDA in infancy on cognitive performance and behavior. These findings reinforce the need for education regarding the risks associated with prenatal alcohol exposure.