{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:09:07Z","timestamp":1785409747207,"version":"3.56.0"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fogarty International Center of the National Institutes of Health","award":["U01TW010087"],"award-info":[{"award-number":["U01TW010087"]}]},{"name":"Fogarty International Center of the National Institutes of Health","award":["U2RTW010104"],"award-info":[{"award-number":["U2RTW010104"]}]},{"award":["U01TW010087"],"award-info":[{"award-number":["U01TW010087"]}],"id":[{"id":"https:\/\/ror.org\/02xey9a22","id-type":"ROR","asserted-by":"publisher"}]},{"award":["U2RTW010104"],"award-info":[{"award-number":["U2RTW010104"]}],"id":[{"id":"https:\/\/ror.org\/02xey9a22","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoX"],"abstract":"<jats:p>Maternal anemia and prenatal exposure to neurotoxic metals are widespread in low- and middle-income countries and may affect early childhood development. In Suriname, where mercury contamination from artisanal gold mining and social disparities coexist, we examined associations between maternal anemia, prenatal exposure to mercury (Hg), lead (Pb), manganese (Mn), selenium (Se), and cadmium (Cd), and early neurodevelopment. The study included 755 pregnant women and 644 children (10\u201326 months) from the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort. Maternal anemia was defined using WHO criteria for Hb, metals were measured in maternal blood, and child development was assessed using the Bayley Scales of Infant and Toddler Development, third edition (BSID-III-NL). Analyses used non-parametric tests, correlations, and multivariable regression. Anemia, though common (34%), was not independently associated with cognitive, language, motor, or social\u2013emotional outcomes. However, iron status was not directly measured; therefore, the absence of an observed association should not be interpreted as evidence that maternal iron deficiency is unrelated to early neurodevelopment. Pb showed the most consistent associations, with higher prenatal levels predicting poorer cognitive, motor, and language scores. Hg demonstrated weaker but significant negative associations with several domains, while Mn and Cd showed limited direct effects. Interaction analyses suggested a potential modifying role of Se in certain metal-neurodevelopment associations; however, these findings require confirmation in future studies. Overall, these results suggest that prenatal exposure to neurotoxic metals and sociodemographic disparities may be important contributors to variation in early neurodevelopment in this population, but causal inferences cannot be made from this cross-sectional analysis.<\/jats:p>","DOI":"10.3390\/jox16030110","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:14:58Z","timestamp":1781180098000},"page":"110","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Anemia and Pediatric Neurodevelopment in Children from Mothers Exposed to Mixed Heavy Metals in Suriname"],"prefix":"10.3390","volume":"16","author":[{"given":"Anisma R.","family":"Gokoel","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simran F.","family":"Mokiem","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname"},{"name":"Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2364-2893","authenticated-orcid":false,"given":"Ashna D.","family":"Hindori-Mohangoo","sequence":"additional","affiliation":[{"name":"Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9264-883X","authenticated-orcid":false,"given":"Maureen Y.","family":"Lichtveld","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-9894","authenticated-orcid":false,"given":"Jeffrey K.","family":"Wickliffe","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences, School of Public Health, University of Alabama, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4080-3858","authenticated-orcid":false,"given":"Wilco C. W. R.","family":"Zijlmans","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname"},{"name":"Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1080\/10408398.2016.1274285","article-title":"Effects of prenatal iron status on child neurodevelopment and behavior: A systematic review","volume":"58","author":"Canals","year":"2018","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.ajog.2020.03.006","article-title":"Iron deficiency in pregnancy","volume":"223","author":"Georgieff","year":"2020","journal-title":"Am. J. Obstet. 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