Anemia at Birth: Ethiopian Study Highlights Urgent Need for Stronger Maternal Nutrition

A large review of studies from major Ethiopian universities shows that over one in four Ethiopian newborns is anemic, mainly due to maternal anemia, poor antenatal care, low birth weight, and inadequate maternal nutrition. The researchers urge stronger pregnancy care, iron–folic acid supplementation, and nutrition support to prevent this avoidable early-life health risk.

A coalition of researchers from Debre Markos University, Injibara University, Bahir Dar University, the University of Gondar, Debre Tabor University, and Addis Ababa–based institutions has drawn national attention to an overlooked but deeply consequential health issue: anemia in newborns. Their systematic review and meta-analysis, covering seven studies conducted between 2015 and 2024 and involving 1,703 infants, reveals that 26.53% of Ethiopian newborns are anemic at birth, a rate the World Health Organization classifies as a moderate public health concern. In a country where neonatal survival remains fragile, this finding elevates newborn anemia from a clinical footnote to a national priority.

Why Newborn Anemia Matters

Though anemia is widely recognized as a threat to women and young children, its impact on newborns has received far less attention. The condition compromises oxygen delivery in the earliest moments of life, leading to rapid breathing, poor feeding, pallor, lethargy, and impaired tissue function. If untreated, newborn anemia can produce lifelong consequences: chronic heart issues, repeated infections, reduced motor and social development, growth delays, bone abnormalities, and cognitive deficits. The authors argue that the cumulative effect of these challenges extends into adulthood, limiting productivity and shaping the country’s long-term economic trajectory.

How the Evidence Was Pieced Together

The research team followed PRISMA guidelines and screened 336 records from global databases and local university archives. After rigorous quality checks, only seven observational studies met the inclusion criteria. These studies came from the Amhara, Oromia, and Addis Ababa regions, giving a useful, though incomplete, snapshot of the national situation. The consistency across studies enabled a fixed-effect model, which confirmed both the prevalence and the strength of associated factors. Although the geographic scope is limited and all included studies were cross-sectional, the findings present the clearest national picture yet of newborn anemia in Ethiopia.

Maternal Health: The Heart of the Problem

A central message emerges from the analysis: newborn anemia is largely rooted in maternal health and nutrition. Maternal anemia was one of the strongest predictors, increasing the odds of newborn anemia by 71 percent. Because the fetus draws iron directly from the mother’s stores, her deficiency becomes the baby’s deficiency. Poor placental function in anemic mothers can further restrict oxygen and nutrient transfer, compounding the risk.

Maternal health service utilization also plays a pivotal role. Mothers who attended fewer than four antenatal care (ANC) visits were more than twice as likely to deliver an anemic newborn. ANC is essential for detecting maternal anemia, offering nutritional counseling, and ensuring access to iron–folic acid (IFA) supplements. Yet poor adherence to IFA supplementation, defined as taking tablets fewer than four days a week, also surfaced as a major risk factor. Given pregnancy’s rising iron demands, supplements are critical in a context where diets often lack sufficient iron.

The analysis also highlights low birth weight (LBW) as a significant contributor. LBW infants, who often face growth restrictions and immature immune systems, were 80 percent more likely to be anemic. A more encouraging finding relates to maternal vegetable consumption: mothers who regularly consumed vegetables significantly reduced the likelihood of anemia in their newborns. Vegetables supply iron, folate, vitamin C, and antioxidants, components essential for red blood cell development.

A Call for Action

Though limitations exist, including the scarcity of studies from several regions and the cross-sectional nature of the data, the overarching conclusion is unmistakable: newborn anemia in Ethiopia is preventable, but doing so requires strengthening maternal health systems. The authors call for intensified ANC engagement, routine anemia screening, improved IFA supplement access and adherence, nutrition counseling focused on vegetable intake, and targeted monitoring for high-risk groups such as low-birth-weight infants. With coordinated effort from healthcare providers, policymakers, and community leaders, Ethiopia can dramatically reduce the burden of newborn anemia and ensure healthier starts for its youngest generation.