Zhang Y L, Zheng S S, Zhu L Y, Ji C, Angulo-Barroso R M, Lozoff B, Shao J
Division of Child Health Care, Children's Hospital Zhejiang University School of Medicine, Hangzhou 310003, China.
Department of Kinesiology, California State University, Northridge, 91330 USA.
Zhonghua Er Ke Za Zhi. 2019 Mar 2;57(3):194-199. doi: 10.3760/cma.j.issn.0578-1310.2019.03.007.
To clarify the impact of pre- and postnatal iron deficiency on children's motor development. This was a longitudinal follow-up study. A total of 114 infants (58 boys, 56 girls) born from April 2010 to December 2011 in Fuyang district of Hangzhou were enrolled. Based on cord blood and 9-month iron status, subjects were divided into prenatal iron deficiency (34 children), postnatal iron deficiency (37 children) and non-iron deficiency group (43 children). Peabody Developmental Motor Scale and BOT2-simplified version were used to evaluate the motor capacity in infants and preschoolers at 9 months, 18 months and 5 years, respectively. Hierarchical linear modeling (HLM) was used to investigate the trajectory of motor development with age, the influence of different timing of early iron deficiency on children's motor development, and the differences (adjusted for possible confounding factors) in motor development in children with pre- or postnatal iron deficiency or non-iron deficiency in different family educational environment. At the age of 9 months, 18 months and 5 years, 107, 109, and 114 children were evaluated respectively. After controlling for a variety of confounding factors, it was found that children with prenatal iron deficiency had significantly lower scores of motor development compared with non-iron deficiency children (52.04 54.05 scores, β=-2.01, 0.007), and that children with postnatal iron deficiency had similar scores of motor development compared with non-iron deficiency children, showing no significant difference (53.07 54.05 scores, β=-0.98, 0.180). Regardless of the maternal education status, prenatal iron deficiency children always had lower motor scores than non-iron deficiency children (49.86 52.15 and 49.58 51.58 scores, β=-2.29, -2.00; 0.031, 0.049). Among the non-iron deficiency children, those whose mothers had a higher education level had higher motor scores compared with those whose mothers had a lower education level (52.45 50.46 scores, β=1.99, 0.035). The motor development of children with prenatal iron deficiency did not catch up with their counterparts without iron deficiency by 5 years of age. The results indicate the importance of preventing iron deficiency in the fetus.
为阐明产前和产后缺铁对儿童运动发育的影响。这是一项纵向随访研究。共纳入了2010年4月至2011年12月在杭州富阳区出生的114名婴儿（58名男孩，56名女孩）。根据脐带血和9个月时的铁状况，将研究对象分为产前缺铁组（34名儿童）、产后缺铁组（37名儿童）和非缺铁组（43名儿童）。分别使用皮博迪发育运动量表和BOT2简化版在9个月、18个月和5岁时评估婴儿和学龄前儿童的运动能力。采用分层线性模型（HLM）研究运动发育随年龄的轨迹、早期缺铁不同时间对儿童运动发育的影响，以及在不同家庭教育环境下产前或产后缺铁或非缺铁儿童运动发育的差异（校正可能的混杂因素后）。在9个月、18个月和5岁时，分别对107名、109名和114名儿童进行了评估。在控制了各种混杂因素后，发现产前缺铁儿童的运动发育得分显著低于非缺铁儿童（52.04对54.05分，β=-2.01，P=0.007），产后缺铁儿童的运动发育得分与非缺铁儿童相似，无显著差异（53.07对54.05分，β=-0.98，P=0.180）。无论母亲的教育状况如何，产前缺铁儿童的运动得分始终低于非缺铁儿童（49.86对52.15分和49.58对51.58分，β=-2.29，-2.00；P=0.031，0.049）。在非缺铁儿童中，母亲教育水平较高的儿童运动得分高于母亲教育水平较低的儿童（52.45对50.46分，β=1.99，P=0.035）。产前缺铁儿童的运动发育在5岁时仍未赶上非缺铁儿童。结果表明预防胎儿缺铁的重要性。
