from Mothers Exposed to Mixed Heavy Metals in Suriname

Overview

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correlations, and multivariable regression. Anemia, though common (34%), was not in-
worldwide prevalence is highest among children under five years (39.8%) (6). Among
pregnant women global prevalence of anemia was 36.5% (7). The highest prevalence (60%)
aged 6–59 months is 33.9% in Mexico and Central America, 46.2% in South America, and
42.9% in the Caribbean. The average prevalence of anemia among nonpregnant women of
childbearing age is 22.5% (16.3% in Mexico and Central America, 24.2% in South America,
in Mexico and Central America, 34.5% in South America, and 42.5% in the Caribbean) (9).
World Health Organization reports an overall 26.9% mild-to-severe anemia prevalence
a prevalence of 55% (unpublished results). A study in the remote tropical rainforest
with a reported 63% of women affected (Medical Mission Primary Health Care Suriname,
prevalence rates for children 6–59 months (25.9%) (6), considerably lower than what was
anemia cases (1.7%).
Maternal Hb levels ranged from 3.2 to 12.9 mmol/L and were normally distributed
(mean ± standard deviation 6.6 ± 1.0 mmol/L). The prevalence of maternal anemia based
on the WHO definition of Hb < 6.2 mmol/L was 34%. General characteristics of the
study population, stratified for subgroups of maternal anemia, are presented in Table 1.
births (38% vs. 31% for those with lower parity) and among Creole (49%) and Tribal
(41%) participants. The majority of the participants with a lower secondary or vocational
education (69%) had moderate or severe anemia. The highest prevalence of moderate or
severe anemia was observed in the 1500–2999 SRD household income group (40%). The
values compared with participants with mild or no anemia (2.55 vs. 3.30 µg/L; p < 0.001).
Participants with moderate or severe anemia had significantly higher median Cd (0.22 vs.
0.18 µg/L; p < 0.001) and median Mn (14.40 vs. 12.80 µg/L; p = 0.004) values compared
Table 1. General characteristics of the study population stratified by subgroups of maternal anemia.
Total 252 33% 501 67% 753
Creole 83 49% 85 51% 168
Hindustani 44 29% 107 71% 151
Tribal people 58 41% 82 59% 140
Total 253 34% 502 66% 755
lower secondary/vocational 102 41% 147 59% 249
upper secondary/vocational and tertiary 102 31% 226 69% 328
Total 253 34% 502 66% 755
Total 243 33% 490 67% 733
Total 253 34% 502 66% 755
Hg median (IQR) µg/L 2.55 (1.52–4.71) 3.30 (1.95–6.62) 755 <0.001
Pb median (IQR) µg/dL 1.98 (1.30–3.10) 1.86 (1.21–3.85) 755 0.976
Cd median (IQR) µg/L 0.22 (0.15–0.32) 0.18 (0.12–0.26) 755 <0.001
- SRD = Surinamese dollar, equivalent to 0.38 USD (26). IQR = Interquartile Range. Bold indicates significance.
factors is presented in Table 2. Parity was significantly associated with cognitive (p = 0.017),
and expressive communication (p < 0.001) scores. Higher mean ranks were noted with a
Table 2. Distribution of Bayley scaled scores for maternal anemia and maternal sociodemographics.
Creole (n = 138) 312.70 337.99 339.22 320.39 338.88 302.42

Methods (brief)

Maternal biospecimens were collected at two time points during pregnancy: late
as it corresponded with the timing of the Hb assessment. Maternal blood samples were
tested for trace elements Hg, Pb, Cd, and Mn. These samples were sent to the Wisconsin
Center, and were tested using inductively coupled plasma-mass spectrometry or cold-
vapor atomic fluorescence spectrometry (CVAFS) (11). The trace metals were evaluated
considered appropriate given the relatively large sample size (n = 644) and the robustness
diverse sample from a LMIC setting, which enhances the generalizability of the findings
velopment, were collected as part of the CCREOH study but were beyond the scope of the
CVAFS Cold Vapor Atomic Fluorescence Spectrometry

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Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.

Commit	Date	Change	Description
b01ec52c	2026-08-04	major	2 sections added
d49e450f	2026-08-03	major	5 sections added; narrative text revised