Low iron risks poor cognitive scores

Chronic iron deficiency in infancy may lead to long-term cognitive deficits, even with early intervention, reports a US-led study of Costa Rican children.

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By  Healthcare Middle East Published  December 6, 2006

Chronic iron deficiency in infancy may lead to long-term cognitive deficits, even with early intervention, reports a US-led study of Costa Rican children. The longitudinal study, through to age 19, showed that chronically iron-deficient children in both middle-class and poor families consistently had lower intelligence scores compared with their healthy peers. Children in poorer families fared worse, found Dr Betsy Lozoff of the University of Michigan in Ann Arbor, who led the study. The 185 urban Costa Rican children included in the study were followed from the age of one or two years old, to age 19. Serum measures of iron status and a range of cognitive tests were administered approximately every five years. Chronic iron deficiency, defined as having a serum ferritin concentration less than 12 ng/mL and either a free erythrocyte protoporphyrin level of at least 100 µg/dL red blood cells or transferring saturation less than 10%, was found in 20 of 87 middle-class children, and 33 of 98 low economic status children. The deficiency remained despite iron treatment sufficient to correct anaemia. Chronically iron-deficient babies born into middle-class families consistently had 8% to 9% lower intelligence score then their healthy peers. For children in poorer families, the gap also appeared to widen over time, from 25% to 28% lower cognitive scores. “Those in lower-socioeconomic status families seemed doubly burdened,” wrote Lozoff and colleagues. “In an economically stressed family environment, there might not be the resources or capacity to help children compensate, (which results) in a worse outcome among individuals who experience both an early biological insult or stressor and more disadvantaged background.” The pattern of increasingly poor cognitive scores could also be explained by the “cumulative and transactional nature of cognitive development,” the authors noted, suggesting the “snowball effect” of early iron deficiency may have disrupted basic development skills. The authors conclude that, as good iron status in infancy appeared to have a protective effect in low-income families, “it seems reasonable to prevent iron deficiency in infancy and treat it before it becomes chronic or severe.” The study was published in the Archives of Pediatrics & Adolescent Medicine.

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