East Patricia, Delker Erin, Blanco Estela, Encina Pamela, Lozoff Betsy, Gahagan Sheila
Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, Mail Code 0927, La Jolla, CA, 92093-0927, USA.
Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.
Matern Child Health J. 2019 Sep;23(9):1240-1250. doi: 10.1007/s10995-019-02764-x.
Infants who are iron-deficient anemic seek and receive less stimulation from their caregivers, predisposing such children to be functionally isolated.
To test the sequence whereby iron deficiency in infancy contributes to children's disengagement from the environment, which reduces parent stimulation which, in turn, contributes to children's poor verbal skills.
Chilean children (N = 875, 54% male) were studied, 45% of whom were iron deficient or iron-deficient anemic in infancy. We used structural equation modeling to test the sequence outlined above and to examine the effect of infant iron status on children's verbal performance at ages 5 and 10 years including the roles of child and parent intermediate variables.
Severity of iron deficiency in infancy was associated with higher levels of children's dull affect and social reticence at 5 years (β = .10, B = .26, SE = .12, p < .05), and these behaviors were associated with parent unresponsiveness (β = .29, B = .13, SE = .03, p < .001), which related to children's lower verbal abilities at age 5 (β = - .29, B = - 2.33, SE = .47, p < .001) and age 10 (β = - .22, B = - 3.04, SE = .75, p < .001). An alternate model where poor iron status related directly to children's verbal ability was tested but not supported.
Findings support functional isolation processes resulting from a nutritional deficiency, with iron-deficient anemic infants showing affective and behavioral tendencies that limit developmentally stimulating caregiving which, in turn, hinder children's verbal abilities.
缺铁性贫血的婴儿从照顾者那里寻求并获得的刺激较少，这使得这类儿童容易出现功能隔离。
检验婴儿期缺铁导致儿童与环境脱离的顺序，这种脱离会减少父母的刺激，进而导致儿童语言能力较差。
对智利儿童（N = 875，54%为男性）进行研究，其中45%在婴儿期缺铁或患有缺铁性贫血。我们使用结构方程模型来检验上述顺序，并考察婴儿铁状态对儿童5岁和10岁时语言表现的影响，包括儿童和父母中间变量的作用。
婴儿期缺铁的严重程度与儿童5岁时更高水平的情绪低落和社交沉默有关（β = 0.10，B = 0.26，SE = 0.12，p < 0.05），这些行为与父母的无反应性有关（β = 0.29，B = 0.13，SE = 0.03，p < 0.001），而这又与儿童5岁时较低的语言能力有关（β = -0.29，B = -2.33，SE = 0.47，p < 0.001）以及10岁时较低的语言能力有关（β = -0.22，B = -3.04，SE = 0.75，p < 0.001）。我们检验了一个缺铁状态直接与儿童语言能力相关的替代模型，但未得到支持。
研究结果支持了由营养缺乏导致的功能隔离过程，缺铁性贫血婴儿表现出的情感和行为倾向会限制具有发育促进作用的照料，进而阻碍儿童的语言能力。
