Akman M, Cebeci D, Okur V, Angin H, Abali O, Akman A C
Department of Family Medicine, Marmara University, School of Medicine, Istanbul, Turkey.
Acta Paediatr. 2004 Oct;93(10):1391-6.
To assess the effects of iron deficiency on developmental test scores in infants.
This prospective, single-blind, controlled clinical intervention study was made on 108 children aged 6-30 mo who applied to our paediatric outpatient clinic. The cases were classified as control (n = 31, haemoglobin > or = 11 g/dl, serum ferritin > 12 microg/l, MCV > or = 70 fl), non-anaemic iron deficiency (NAID, n = 40, haemoglobin > or = 11 g/dl, serum ferritin < or = 12 microg/l, MCV > or = 70 fl) and iron deficiency anaemia (IDA, n = 37, haemoglobin < 11 g/dl, ferritin < or = 12 microg/l, MCV < 70 fl) due to their anaemia status. In each group, MCV, haemoglobin and ferritin levels were measured, and Denver Developmental Screening Test (DDST) and Bayley Scales of Infant Development (BSID-I) were administered before and after a 3-mo follow-up. IDA and about half of the NAID subjects were treated with oral iron for 3 mo.
Subjects with iron deficiency showed significantly lower developmental test scores both with BSID-I and DDST-II compared to their iron-sufficient peers (p < 0.05). After 3 mo of iron treatment, lower mental developmental test scores were no longer observed among the IDA and NAID groups whose anaemia and iron deficiency were also corrected. No significant differences were found between control NAID and control IDA groups on DGTT-II results after treatment. The difference in motor and mental developmental scores did not appear to depend on environmental and family factors considered in the analyses.
These findings support the conclusions that iron deficiency may cause lower mental and motor test scores in infants and these adverse effects can be improved by iron therapy.
评估缺铁对婴儿发育测试分数的影响。
本前瞻性、单盲、对照临床干预研究针对108名6至30个月大、前来我院儿科门诊就诊的儿童开展。根据贫血状况，将病例分为对照组（n = 31，血红蛋白≥11 g/dl，血清铁蛋白> 12 μg/l，平均红细胞体积≥70 fl）、非贫血性缺铁组（NAID，n = 40，血红蛋白≥11 g/dl，血清铁蛋白≤12 μg/l，平均红细胞体积≥70 fl）和缺铁性贫血组（IDA，n = 37，血红蛋白< 11 g/dl，铁蛋白≤12 μg/l，平均红细胞体积< 70 fl）。每组均测量平均红细胞体积、血红蛋白和铁蛋白水平，并在3个月随访前后进行丹佛发育筛查测试（DDST）和贝利婴儿发育量表（BSID-I）测试。IDA组和约一半的NAID组受试者接受了3个月的口服铁剂治疗。
与铁充足的同龄人相比，缺铁受试者在BSID-I和DDST-II测试中的发育测试分数显著更低（p < 0.05）。经过3个月的铁剂治疗后，贫血和缺铁得到纠正的IDA组和NAID组中，不再观察到较低的智力发育测试分数。治疗后，对照组NAID组和对照组IDA组在DDST-II结果上未发现显著差异。运动和智力发育分数的差异似乎并不取决于分析中考虑的环境和家庭因素。
这些发现支持以下结论，即缺铁可能导致婴儿智力和运动测试分数降低，并且这些不良影响可通过铁剂治疗得到改善。
