Paper Published in BMJ Global Health Examines Hemoglobin Thresholds Linked to Child Development Outcomes

A new international study, led by researchers at the University of California, Davis, provides important evidence to help refine how anemia is defined in young children worldwide.

Published in BMJ Global Health, the study analyzed data from more than 27,000 children aged 6 to 30 months across eight low- and middle-income countries. Researchers examined how hemoglobin (Hb) levels, a key indicator of anemia, relate to children’s physical activity, sleep, and early development.

One of the key findings suggests that higher hemoglobin concentration cutoffs better predicted future adverse outcomes whereas lower concentrations predicted concurrent adverse effects, indicating that marginally low hemoglobin concentrations may not be associated with developmental impairments in the short term, but problems may emerge 6-18 months later.

The researchers emphasize that hemoglobin thresholds should not be based solely on statistical norms but also on how levels relate to children’s real-world functioning. They suggest that this evidence, combined with other data, could support more precise and context-specific definitions of anemia.

We would like to acknowledge our dear late colleague Beth Prado, who originally initiated this work and contributed to the early development of the manuscript. We are pleased to see the paper finally come to publication and grateful for her foundational contributions to this effort.

Citation: Prado, Elizabeth L et al. “Hemoglobin concentration thresholds that discriminate functional outcomes among children aged 6-30 months in eight countries: a pooled analysis of individual participant data.” BMJ Global Health vol. 11,4 e015866. 28 Apr. 2026, doi:10.1136/bmjgh-2024-015866