Iron-Deficiency Anemia and School Functioning among Children and Adolescents in Saudi Arabia: A Cross-Sectional Study

Abstract

Anemia is common among children and adolescents and is associated with reduced attention and academic achievement. However, evidence regarding its relationship with school functioning in Saudi Arabia remains limited. This study examined the association between reported iron-deficiency anemia (IDA) status and school attendance, academic performance, and academic competence among children and adolescents in Saudi Arabia. A quantitative cross-sectional study used a structured self-administered online questionnaire distributed to parents of children and adolescents aged 6-18 years. The final analytical sample comprised 167 participants. Of the 167 participants, 113 (67.7%) had a reported IDA diagnosis. Pearson’s chi-square analysis showed a significant association between reported IDA status and school absence exceeding five days per semester (χ² = 6.49, p = 0.039). No significant associations were found with late school arrival, overall academic performance, or performance compared with classmates. Total academic competence scores did not differ significantly between children and adolescents with and without reported IDA (22.84 ± 4.10 vs. 23.07 ± 3.46, t = 0.30, p = 0.761). However, difficulty remembering lessons was significantly associated with reported IDA status (χ² = 10.49, p = 0.033). These findings require cautious interpretation given the cross-sectional design, non-probability sampling, and reliance on reported measures. Future research should employ representative samples, laboratory-based iron status assessment, validated academic and cognitive measures, and official school records to clarify these associations.