Angulo-Barroso Rosa M, Li Ming, Santos Denise C C, Bian Yang, Sturza Julie, Jiang Yaping, Kaciroti Niko, Richards Blair, Lozoff Betsy
Department of Kinesiology, California State University, Northridge, Northridge, California; Center for Human Growth and Development, and
Department of Pediatrics, and.
Pediatrics. 2016 Apr;137(4). doi: 10.1542/peds.2015-3547. Epub 2016 Mar 2.
Insufficient iron levels for optimal fetal and infant development is a concern during pregnancy and infancy. The goal of this study was to assess the effects of iron supplementation in pregnancy and/or infancy on motor development at 9 months.
The study was a randomized controlled trial (RCT) of infancy iron supplementation linked to an RCT of pregnancy iron supplementation, conducted in Hebei, China. A total of 1482 infants were randomly assigned to receive placebo (n = 730) or supplemental iron (n = 752) from 6 weeks to 9 months. Gross motor development (assessed by using the Peabody Developmental Motor Scale, Second Edition, instrument) was the primary outcome. Neurologic integrity and motor quality were secondary outcomes.
Motor outcome was available for 1196 infants, divided into 4 supplementation period groups: (1) placebo in pregnancy/placebo in infancy (n = 288); (2) placebo in pregnancy/iron in infancy (n = 305); (3) iron in pregnancy/placebo in infancy (n = 298); and (4) iron in pregnancy/iron in infancy (n = 305). Using the Peabody Developmental Motor Scale, instrument, iron supplementation in infancy but not pregnancy improved gross motor scores: overall, P < .001; reflexes, P = .03; stationary, P < .001; and locomotion, P < .001. Iron supplementation in infancy improved motor scores by 0.3 SD compared with no supplementation or supplementation during pregnancy alone. Effects of iron supplementation in infancy alone were similar to effects with iron in both pregnancy and infancy.
The RCT design supports the causal inference that iron supplementation in infancy, with or without iron supplementation in pregnancy, improved gross motor test scores at 9 months.
孕期和婴儿期铁水平不足无法满足胎儿和婴儿的最佳发育需求，这是一个值得关注的问题。本研究的目的是评估孕期和/或婴儿期补充铁对9个月时运动发育的影响。
本研究是一项在中国河北进行的关于婴儿期铁补充的随机对照试验（RCT），该试验与孕期铁补充的RCT相关联。共有1482名婴儿被随机分配，从6周龄至9月龄接受安慰剂（n = 730）或铁补充剂（n = 752）。粗大运动发育（使用第二版皮博迪发育运动量表进行评估）是主要结局。神经完整性和运动质量是次要结局。
1196名婴儿有运动结局数据，分为4个补充期组：（1）孕期安慰剂/婴儿期安慰剂（n = 288）；（2）孕期安慰剂/婴儿期铁剂（n = 305）；（3）孕期铁剂/婴儿期安慰剂（n = 298）；（4）孕期铁剂/婴儿期铁剂（n = 305）。使用皮博迪发育运动量表，婴儿期而非孕期补充铁剂可提高粗大运动评分：总体而言，P < 0.001；反射，P = 0.03；静止，P < 0.001；移动，P < 0.001。与不补充或仅在孕期补充相比，婴儿期补充铁剂使运动评分提高了0.3个标准差。仅婴儿期补充铁剂的效果与孕期和婴儿期都补充铁剂的效果相似。
随机对照试验设计支持因果推断，即婴儿期补充铁剂，无论孕期是否补充铁剂，均可提高9个月时的粗大运动测试评分。
