Risk factors for iron deficiency anemia in infants aged 6 to 12 months and its effects on neuropsychological development
XU Kang1, ZHANG Cui-Mei2, HUANG Lian-Hong1, FU Si-Mao1, LIU Yu-Ling1, CHEN Ang2, OU Jun-Bin1
Department of Pediatrics, Third Medical College, Zhongshan Bo'ai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong 528403, China
Abstract Objective To study the risk factors for moderate and severe iron deficiency anemia (IDA) in infants aged 6-12 months, and to preliminarily investigate the effects of IDA on the neuromotor development and temperament characteristics of infants. Methods A total of 326 infants aged 6-12 months with IDA were classified into three groups: mild IDA (n=176), moderate IDA (n=111), and severe IDA (n=39) according to the severity of anemia. The risk factors for moderate or severe IDA were investigated by multivariate logistic regression analysis. Three hundred and forty-six infants without IDA who showed matched age, sex, and other backgrounds were selected as the control group. The Gesell Development Diagnosis Scale was used to evaluate children's mental development. The Temperament Scale for infants was used for evaluating children's temperament. Results The univariate analysis showed that the severity of IDA was associated with sex, birth weight, gestational age, multiple birth, maternal anemia during pregnancy, and mother's lack of knowledge about IDA (P< 0.05). Setting the mild IDA group as control, the multivariate logistic regression analysis showed that multiple birth, premature birth, low birth weight (< 2 500 g), maternal anemia during pregnancy, breast feeding, and mother's lack of knowledge about IDA were the risk factors for severe IDA (OR> 1;P< 0.05); premature birth, breast feeding, and mixed feeding were the risk factors for moderate IDA (OR> 1; P< 0.05). The IDA group had significantly lower scores in Gesell general development quotient, gross motor, adaptive behavior, and fine motor than the control group (P< 0.05). The IDA group had higher percentages of children with difficulty and intermediate difficulty temperaments than the control group (P< 0.05). The IDA group had significantly higher scores in activity level, rhythmicity, adaptability, and perseverance than the control group (P< 0.05). Conclusions The severity of IDA is associated with premature birth, multiple birth, low birth weight, feeding pattern, maternal anemia during pregnancy and mother's lack of knowledge about IDA in infants aged 6-12 months. Infants with IDA have delayed neuromotor development and most of them have negative temperaments. More attention should be paid to mental and behavior problems for the infants. It is necessary to provide guidance for their parents in feeding and education.
About author:: 10.7499/j.issn.1008-8830.2015.08.014
Cite this article:
XU Kang,ZHANG Cui-Mei,HUANG Lian-Hong et al. Risk factors for iron deficiency anemia in infants aged 6 to 12 months and its effects on neuropsychological development[J]. CJCP, 2015, 17(8): 830-836.
XU Kang,ZHANG Cui-Mei,HUANG Lian-Hong et al. Risk factors for iron deficiency anemia in infants aged 6 to 12 months and its effects on neuropsychological development[J]. CJCP, 2015, 17(8): 830-836.
Mclean E, Cogswell M, Egli I, et al. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005[J]. Public Health Nutr, 2009, 12(4): 444-454.
[2]
Bhutta ZA, Salam RA. Global nutrition epidemiology and trends[J]. Ann Nutr Metab, 2012, 61 (Suppl 1): 19-27.
Vanbuskirk KM, Ofosu A, Kennedy A, et al. Pediatric anemia in rural Ghana: a cross-sectional study of prevalence and risk factors[J]. J Trop Pediatr, 2014, 60(4): 308-317.
Donato H, Cedola A, Rapetti MC, et al. Iron deficiency anemia. Guideline for diagnosis and treatment[J]. Arch Argent Pediatr, 2009, 107(4): 353-361.
[11]
Armony-Sivan R, Kaplan-Estrin M, Jacobson S W, et al. Iron-deficiency anemia in infancy and mother-infant interaction during feeding[J]. J Dev Behav Pediatr, 2010, 31(4): 326-332.
[12]
Gokcay G, Ozden T, Karakas Z, et al. Effect of iron supplementation on development of iron deficiency anemia in breastfed infants[J]. J Trop Pediatr, 2012, 58(6): 481-485.
Golub MS. Recent studies of iron deficiency during brain development in nonhuman primates[J]. Biofactors, 2010, 36(2): 111-116.
[17]
Shafir T, Angulo-Barroso R, Jing Y, et al. Iron deficiency and infant motor development[J]. Early Hum Dev, 2008, 84(7): 479-485.
[18]
Carter RC, Jacobson JL, Burden MJ, et al. Iron deficiency anemia and cognitive function in infancy[J]. Pediatrics, 2010, 126(2): e427-e434.
[19]
Tran TD, Biggs BA, Tran T, et al. Impact on infants' cognitive development of antenatal exposure to iron deficiency disorder and common mental disorders[J]. PLoS One, 2013, 8(9): e74876.
[20]
Prado EL, Dewey KG. Nutrition and brain development in early life[J]. Nutr Rev, 2014, 72(4): 267-284.
[21]
Miller JL. Iron deficiency anemia: a common and curable disease[J]. Cold Spring Harb Perspect Med, 2013, 3(7): 1-13.
Chen MH, Su TP, Chen YS, et al. Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationwide population-based study[J]. BMC Psychiatry, 2013, 13: 161.
[24]
Felt BT, Peirano P, Algarin C, et al. Long-term neuroendocrine effects of iron-deficiency anemia in infancy[J]. Pediatr Res, 2012, 71(6): 707-712.
