Article

Mother-infant interactions and infant development are altered by maternal iron deficiency anemia

School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
Journal of Nutrition (Impact Factor: 4.23). 04/2005; 135(4):850-5.
Source: PubMed

ABSTRACT The aim of this study was to determine whether iron deficiency anemia (IDA) in young South African mothers alters mother-infant interactions and the infant's development. The study was a prospective, randomized, controlled intervention trial with 3 groups of mothers: nonanemic controls and anemic mothers administered either placebo (25 mg ascorbic acid and 10 microg folate) or daily iron treatment (125 mg FeSO(4) plus ascorbate and folate). Mothers of full-term, normal birth weight infants (n = 81) were followed from 10 wk to 9 mo postpartum. Maternal iron status, socioeconomic level, mother-infant interaction [Parent/Caregiver Involvement Scale (PCIS scale)], and infant development (Griffiths scale) were assessed. At baseline, anemic mothers tended (P < 0.10) to be less responsive to, and more controlling of, their infants. Infants of anemic mothers were developmentally delayed at 10 wk in hand-eye movement and overall quotient. Despite normalization of maternal iron status with supplementation in some mothers, the developmental delays were not diminished at 9 mo. At 9 mo, anemic mothers were significantly more "negative" towards their babies, engaged less in goal setting, and were less "responsive" than control mothers. In contrast, the behavior of anemic mothers given iron treatment toward their children was similar to that of the control mothers on all 11 scales of the PCIS. In conclusion, IDA altered mother-child interactions at both 10 wk and 9 mo postpartum. Additionally, infants whose mothers were anemic in the early postpartum scored worse on developmental tests at 10 wk and 9 mo of age.

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    • "Approximately 21% of women in high-income countries experience postpartum anemia, a condition characterized by tiredness, maternal infections, depression, and impairments in mother–child interactions and infant development [1] [2] [3] [4]. Treatment of postpartum anemia could, therefore, contribute to maternal health and infant development. "
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    ABSTRACT: Objective To evaluate the efficacy of adding folic acid to oral iron supplementation in postpartum women with anemia. Methods A randomized controlled trial was conducted in the Netherlands between April 8, 2008, and August 31, 2010. A total of 112 postpartum women with anemia (hemoglobin < 10.5 g/dL) were randomly allocated to receive 600 mg/day ferrous fumarate plus 1 mg/day folic acid (FFFA group) or 600/day ferrous fumarate alone (FF group) for 4 weeks. Primary outcome measures were hemoglobin and health status. Secondary outcome measures were fatigue, compliance, and adverse reactions. Results No between-group differences were observed in hemoglobin and health status after treatment, and no differences were found in fatigue scores. Approximately 75% of all women reported having at least one symptom resulting from ferrous fumarate use. Constipation caused by ferrous fumarate was significantly associated with non-compliance (P = 0.014). Conclusion The addition of folic acid to iron supplementation is not beneficial in women with postpartum anemia, as it has no effect on hematologic or health status parameters. Clinical Trial Registration: CCMO website NL21797.028.08 and Netherlands Trial Register NTR2232.
    International Journal of Gynecology & Obstetrics 08/2014; DOI:10.1016/j.ijgo.2014.02.013 · 1.56 Impact Factor
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    • "This type of fatigue is not an isolated physical symptom, but involves lethargy, decreased mental alertness, physical weakness, and poor concentration [8]. Uncorrected IDA may have a negative impact on maternal cognition, mood and behavior, and could thereby alter mother-child interactions [9] [10]. Therefore, health status (HS), a multidimensional concept that incorporates the self-perceived functioning of physical, psychological, and social aspects of life [11], is regarded as reduced in women with postpartum anemia [1]. "
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    ABSTRACT: Objective: The incidence of postpartum anemia is high. Current therapy consists of iron supplementation or blood transfusions, based on the assumption that these treatments improve health status (HS) and reduce fatigue. The aim of this study was to compare HS and fatigue in postpartum women with and without anemia. Study design: This prospective cohort study was performed in The Netherlands between April 2008 and August 2010 and involved 112 anemic (hemoglobin [Hb] < 10.5 g/dL) and 108 non-anemic (Hb >= 10.5 g/dL) women. The anemic women received oral iron supplementation. Within 48 h and 5 weeks after delivery, HS was measured using the 36 item Short-Form Health Survey (SF-36) and fatigue was measured using the Checklist Individual Strength (CIS). ANOVA for repeated measures was used to compare HS and fatigue scores among groups and across time. Results: After adjustment for confounding variables, there were no differences in any of the HS and fatigue scores. HS and fatigue seem to be more influenced by a complicated delivery than by anemia. HS and fatigue scores significantly improved over time in all women. Conclusion: HS and fatigue were not different among women with and without postpartum anemia.
    European Journal of Obstetrics & Gynecology and Reproductive Biology 08/2014; 181C:119-123. DOI:10.1016/j.ejogrb.2014.07.028 · 1.63 Impact Factor
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    • "IDA in children requiring hospitalization was asso - ciated with increased behavioral problems post - hospitalization compared with children who were hospitalized for other reasons ( Werkman et al. 1964 ) . Infants and preschoolers with IDA have measurably worse behavior and more problems with affect when compared with iron - sufficient controls ( Perez et al . 2005 ; Lozoff et al . 2007 ) . Several studies have found a negative association between ADHD symptom severity and ferritin levels ( those with lower ferritin levels had more ADHD symptoms ) ( Sever et al . 1997 ; Starobrat - Hermelin 1998 ; Konofal et al . 2004 , 2007 ; Oner et al . 2007 ; Cortese et al . 2008 ; Oner and Oner 2008 ; Oner et"
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    ABSTRACT: Abstract Objective: Iron plays a key role in brain function, and a deficiency of iron has been implicated in various cognitive, motor, and psychiatric disorders. Because of recent evidence that iron deficiency may be related to attention-deficit/hyperactivity disorder (ADHD) and other psychiatric disorders, the goal of this study was to compare the iron status of children and youth seen in a community mental health clinic with a national sample of same-aged subjects. Methods: In this study, a consecutive series of 108 patients (79 males) referred to a community mental health clinic was compared with a National Health and Nutrition Examination Survey (NHANES) sample on measures of iron status. Wilcoxon sign rank and median tests were used to compare distributions of ferritin. Quantile regression was performed to compare the ferritin level in the two samples while adjusting for demographic differences. Chi squared (χ2) was used to compare rates of low hemoglobin in the two samples. Results: The iron status of the clinic sample, as measured by ferritin levels (median=23 μg/L), was significantly lower than that of the national sample (median=43 μg/L). After adjustment for age, gender, and race, the clinic sample was found to have 19.2 μg/L lower ferritin than the national sample (95%CI from 7.6 to 30.9, p value=0.001). There were also significantly more subjects in the clinic sample with low hemoglobin than in the national sample. There were no differences in ferritin levels between those patients in the clinic sample with and without an ADHD or other specific psychiatric diagnosis. Conclusions: The ferritin levels of children and youth in a mental health clinic sample were significantly lower than those of the same-aged subjects in a national sample. Therefore, compromised iron status may be an additional biological risk factor for cognitive, behavioral, and psychiatric problems in pediatric populations served by the community mental health clinic.
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