Iron deficiency anemia and iron therapy: Effects on infant developmental test performance

Pediatrics (Impact Factor: 5.47). 07/1987; 79(6):981-95.
Source: PubMed


The behavioral effects of iron deficiency and its treatment were evaluated in a double-blind randomized controlled community-based study of 191 Costa Rican infants, 12 to 23 months of age, with various degrees of iron deficiency. The Bayley Scales of Infant Development were administered before and both 1 week and 3 months after IM or oral administration of iron. Appropriate placebo-treated control infants were also tested. Infants with iron deficiency anemia showed significantly lower mental and motor test scores, even after considering factors relating to birth, nutrition, family background, parental IQ, and the home environment. After 1 week, neither IM nor oral iron treatments differed from placebo treatment in effects on scores. After 3 months, lower mental and motor test scores were no longer observed among iron-deficient anemic infants whose anemia and iron deficiency were both corrected (36%). However, significantly lower mental and motor test scores persisted among the majority of initially anemic infants (64%) who had more severe or chronic iron deficiency. Although no longer anemic, they still showed biochemical evidence of iron deficiency after 3 months of treatment. These persistent lower scores suggest either that iron therapy adequate for correcting anemia is insufficient to reverse behavioral and developmental disturbances in many infants or that certain ill effects are long-lasting, depending on the timing, severity, or chronicity of iron deficiency anemia in infancy.

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    • "mı, demir eksikliğinin santral sinir sisteminde oluşturduğu biyokimyasal değişiklikleri; bir kısmı da öğrenme, algılama ve davranış gibi fonksiyonel etkileri araştırmışlardır. Demir eksikliği olan hayvanlarda, beyinde önemli görevleri olan, serotonin, dopamin gibi nörotransmitter metabolizmalarında değişiklikler olduğu bildirilmiştir (Youdim 1985, Lozoff ve ark. 1987, Kırmızıtaş ve Kılınç 2005). Non-hem (hemoglobine bağlı olmayan) demir, beyinde özellikle ekstrapiramidal alanda dağılım gösterir (Hill ve Switzer 1984). Demir eksikliğinde, striatumda, dopamin D2 reseptörü yoğunluğunda azalma olduğu gösterilmiştir (Youdim 1985). Demir eksikliği olan farelerde , dopaminerjik aktiviteyi azaltan ilaçlarla"
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    ABSTRACT: Dikkat eksikliği ve hiperaktivite bozukluğu, tıp literatüründe en iyi araştırılmış bozukluklardan biri olmasına rağmen, etiyolojisi halen net olarak açıklığa kavuşturulamamıştır. Dikkat eksikliği ve hiperaktivite bozukluğu’nun küratif şekilde tedavi edilmesi için bozukluk ile ilişkili etmenlerin net olarak aydınlatılması oldukça önemlidir. Literatür incelendiğinde, demir eksikliğinin dikkat eksikliği ve hiperaktivite bozukluğu patofizyolojisi için bir risk faktörü olabileceği belirtilmekle birlikte, konu ile ilgili şu ana kadar yapılan çalışmalarda çelişkili sonuçlar elde edildiği gözlenmektedir. Bu yazıda, dikkat eksikliği ve hiperaktivite bozukluğu patofizyolojisinde etkili olduğu düşünülen demir ve demirle ilişkili parametrelerin kan düzeyleri ile ilgili literatürdeki, çocuk ve ergen yaş grubunda, ülkemizde ve yurt dışında yapılmış konu ile ilgili çalışmaların incelenmesi, genel özelliklerinin derlenmesi ve sonuçlarının sunulması amaçlanmıştır.
    Psikiyatride Guncel Yaklasimlar 12/2014; 2015(7(1)):41-55.
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    • "Maternal worm infections co-exist with several important potential confounders, such as maternal under-nutrition (Goldenberg, Hoffman, & Cliver, 1998; Hack, 1998), maternal infections, including HIV and malaria (Gay et al., 1995; Gentile, Boll, Stagno, & Pass, 1989) and exposures in infancy including malaria (Dugbartey & Spellacy, 1997), recurrent diarrhea (Berkman, Lescano, Gilman, Lopez, & Black, 2002), anemia (Clarke, Grantham-McGregor, & Powell, 1991; Lozoff, Brittenham, & Wolf, 1987), malnutrition (Galler, Ramsey, Solimano, Kucharski, & Harrison, 1984; Grantham-McGregor, Powell, Walker, Chang, & Fletcher, 1994), and inadequate social stimulation (Bradley et al., 1989; Grantham-McGregor, Powell, Walker, & Himes, 1991; Ramey & Ramey, 1998). "
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    ABSTRACT: We tested the hypothesis that maternal worm infections in pregnancy affect infant motor and neurocognitive development, and that anthelminthic treatment during pregnancy can reverse these effects. We used measures which examine infant motor, cognitive and executive function, including inhibition. We assessed 983 Ugandan infants aged 15 months, using locally appropriate measures within the Entebbe Mother and Baby Study, a trial of anthelminthic treatment during pregnancy. Key exposures were maternal worm infections and anthelminthic treatment during pregnancy. Effects of other health and social factors were controlled for statistically. Of the five major worm species found in the pregnant women, two had influences on the developmental measures: Maternal Mansonella perstans and Strongyloides stercoralis infections showed negative associations with the A-not B-task, and Language, respectively. Performance on other psychomotor and cognitive measures was associated with illnesses during infancy and infants' behavior during assessment, but not with maternal worm infections. There were no positive effects of maternal anthelminthic treatment on infant abilities. Mansonella perstans and Strongyloides stercoralis infection during pregnancy seem associated with impaired early executive function and language, respectively, but single-dose anthelminthic treatment during pregnancy was not beneficial. The biological mechanisms that could underlie these neurocognitive effects are discussed. (JINS, 2012, 18, 1019-1030).
    Journal of the International Neuropsychological Society 11/2012; 18(6):1019-30. DOI:10.1017/S1355617712000768 · 2.96 Impact Factor
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    • "ID and untreated IDA during pregnancy have many negative consequences for the offspring and have been shown to be associated with a higher incidence of low birth weight and prematurity [14], [15], [16], [17], [18], long-term cognitive abnormalities such as language learning impairments and behavioral changes [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], alteration in thermoregulation [36], changes in lipid metabolism [37], stroke and seizures [38], [39], altered motor function and coordination [40], [41], [42], and in many cases alteration of Auditory Brainstem Responses (ABRs, [35], [43], [44], [45], [46], a measure of nerve impulse conduction in the auditory system). Gestational ID also has been shown to change iron homeostasis in the offspring resulting in increased risk of developing ID later in life despite adequate nutrition [47], [48], [49]. "
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    ABSTRACT: It is well acknowledged from observations in humans that iron deficiency during pregnancy can be associated with a number of developmental problems in the newborn and developing child. Due to the obvious limitations of human studies, the stage during gestation at which maternal iron deficiency causes an apparent impairment in the offspring remains elusive. In order to begin to understand the time window(s) during pregnancy that is/are especially susceptible to suboptimal iron levels, which may result in negative effects on the development of the fetus, we developed a rat model in which we were able to manipulate and monitor the dietary iron intake during specific stages of pregnancy and analyzed the developing fetuses. We established four different dietary-feeding protocols that were designed to render the fetuses iron deficient at different gestational stages. Based on a functional analysis that employed Auditory Brainstem Response measurements, we found that maternal iron restriction initiated prior to conception and during the first trimester were associated with profound changes in the developing fetus compared to iron restriction initiated later in pregnancy. We also showed that the presence of iron deficiency anemia, low body weight, and changes in core body temperature were not defining factors in the establishment of neural impairment in the rodent offspring. Our data may have significant relevance for understanding the impact of suboptimal iron levels during pregnancy not only on the mother but also on the developing fetus and hence might lead to a more informed timing of iron supplementation during pregnancy.
    PLoS ONE 03/2011; 6(3):e17483. DOI:10.1371/journal.pone.0017483 · 3.23 Impact Factor
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