Center for Human Growth and Development, Department of Pediatrics and Communicable Diseases, 300 N Ingalls, University of Michigan, Ann Arbor, MI 48109-5406, USA.
Pediatrics. 2010 Oct;126(4):e884-94. doi: 10.1542/peds.2009-3535. Epub 2010 Sep 20.
Iron-deficiency anemia (IDA) is associated with alterations in infant behavior and development that may not be corrected with iron therapy.
To determine if a home-based intervention to foster child development improves behavior and development of infants with IDA.
Infants with IDA and nonanemic infants aged 6 and 12 months were treated with oral iron and randomly assigned to a year of surveillance or intervention. Infants in the surveillance group were visited weekly, and information on iron intake, feeding, and health were recorded. Infants in the intervention were visited weekly, and the home visits included an hour-long program to foster child development by providing support to the mother-infant relationship. The number of infants enrolled was 128 (66 who received intervention) and 149 (70 intervention) at 6 and 12 months, respectively. Psychologists who were unaware of iron status and intervention assignment assessed infants' cognitive, motor, and social-emotional development (Bayley Scales) at the beginning, midpoint, and end of the year; 116 6-month-olds and 134 12-month-olds had at least 2 assessments. Hierarchical linear modeling was used to analyze change over time.
Infants with IDA, regardless of enrollment age, were rated as less positive in social-emotional behavior at baseline. There were significant interactions between iron status and intervention associated with change in cognitive performance and positive social-emotional behavior. Infants with IDA who received intervention had developmental trajectories comparable to those of nonanemic infants in the intervention and surveillance groups, but these infants did not catch up in social-emotional behavior. Infants with IDA who received surveillance showed less increase in cognitive scores and had declines in positive social-emotional ratings.
Home-based intervention to foster child development improved cognitive and social-emotional scores in infants with IDA, but social-emotional differences remained between infants with IDA and those without IDA.
缺铁性贫血（IDA）与婴儿行为和发育的改变有关，而这些改变可能无法通过铁治疗得到纠正。
确定以家庭为基础的促进儿童发展的干预措施是否能改善 IDA 婴儿的行为和发育。
6 至 12 个月龄的 IDA 婴儿和非贫血婴儿接受口服铁治疗，并随机分配接受一年的监测或干预。监测组的婴儿每周接受一次家访，记录铁摄入量、喂养和健康信息。干预组的婴儿每周接受一次家访，家访包括一个小时的促进儿童发展的计划，通过为母婴关系提供支持来促进儿童发展。分别有 128 名（接受干预的 66 名）和 149 名（干预的 70 名）婴儿在 6 个月和 12 个月时入组。不知道铁状态和干预分配的心理学家在年初、年中和年末评估婴儿的认知、运动和社会情感发展（贝利量表）；116 名 6 个月大的婴儿和 134 名 12 个月大的婴儿至少有 2 次评估。使用分层线性建模分析随时间的变化。
无论入组年龄如何，IDA 婴儿在基线时的社会情感行为评分都较低。铁状态和干预之间存在显著的交互作用，与认知表现和积极社会情感行为的变化有关。接受干预的 IDA 婴儿的发育轨迹与干预组和监测组的非贫血婴儿相似，但他们在社会情感行为方面没有赶上。接受监测的 IDA 婴儿的认知评分增加较少，积极社会情感评分下降。
以家庭为基础的促进儿童发展的干预措施改善了 IDA 婴儿的认知和社会情感评分，但 IDA 婴儿和非 IDA 婴儿之间的社会情感差异仍然存在。
