Article

Iron deficiency and infant motor development

Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan 48109-5406, USA.
Early Human Development (Impact Factor: 1.79). 08/2008; 84(7):479-85. DOI: 10.1016/j.earlhumdev.2007.12.009
Source: PubMed

ABSTRACT

Iron deficiency (ID) during early development impairs myelination and basal ganglia function in animal models.
To examine the effects of iron deficiency anemia (IDA) and iron deficiency (ID) without anemia on infant motor skills that are likely related to myelination and basal ganglia function.
Observational study.
Full-term inner-city African-American 9- to 10-month-old infants who were free of acute or chronic health problems with iron status indicators ranging from IDA to iron sufficiency (n=106). Criteria for final iron status classification were met by 77 of these infants: 28 IDA, 28 non-anemic iron-deficient (NA ID), and 21 iron-sufficient (IS).
Gross motor developmental milestones, Peabody Developmental Motor Scale, Infant Neurological International Battery (INFANIB), motor quality factor of the Bayley Behavioral Rating Scale, and a sequential/bi-manual coordination toy retrieval task. General linear model analyses tested for linear effects of iron status group and thresholds for effects.
There were linear effects of iron status on developmental milestones, Peabody gross motor (suggestive trend), INFANIB standing item, motor quality, and toy retrieval. The threshold for effects was ID with or without anemia for developmental milestones, INFANIB standing item, and motor quality and IDA for toy retrieval.
Using a comprehensive and sensitive assessment of motor development, this study found poorer motor function in ID infants with and without anemia. Poorer motor function among non-anemic ID infants is particularly concerning, since ID without anemia is not detected by common screening procedures and is more widespread than IDA.

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    • "An estimated 25% of pregnancies worldwide are thought to involve iron deficiency anemia (IDA), the most severe form of iron deficiency (Stoltzfus, 2003). This is increasingly recognized as a serious concern for CNS development, as early gestational IDA is associated with long-lasting cognitive abnormalities that affect language learning, behavior, general nerve conductivity (Algarin et al., 2003; Beard, 2003; Lozoff et al., 2008), altered motor function, and coordination (Shafir et al., 2008). Many of the impairments cannot be reversed with iron supplementation, suggesting a critical window of vulnerability exists during early development (Kwik-Uribe et al., 2000; Lozoff et al., 2000). "
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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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    • "Up to 50% of infants in developing countries are estimated to become anaemic by 1 year of age (Gillespie & Johnston 1998), although estimates in many countries well exceed that number, and roughly half of anaemia is estimated to be caused by iron deficiency. Iron deficiency during infancy, even without anaemia, has been shown to negatively affect motor development (Shafir et al. 2008 ), and anaemia caused by iron deficiency is associated with poorer cognitive, motor and/or social/emotional outcomes (Lozoff & Georgieff 2006;). In some studies, negative developmental effects are evident more than 19 years later, even after treatment to correct the anaemia (). "
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