Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
Department of Child Health, Maternity and Child Health Hospital of Baiyun District, Guangzhou 510400, China.
Nutrients. 2021 Sep 28;13(10):3423. doi: 10.3390/nu13103423.
(1) Background: Anemia has comprehensive adverse effects on the growth and development of children. In this study, we analyzed the potential effects of different types of anemia on early-life neurobehavioral development. (2) Methods: A total of 2601 children aged 6-24 months, whose parents agreed to participate in this study, underwent routine blood tests and neurobehavioral development assessment. The children's parents or other primary caregivers were interviewed with a face-to-face questionnaire at the time of enrollment in the study. Anemia was determined by hemoglobin < 110 g/L and classified into iron-deficiency and non-iron-deficiency anemia according to the levels of serum ferritin, C-reactive protein, and alpha-1-acid glycoprotein. Neurobehavioral development was assessed by the China Developmental Scale for Children and divided into five domains: gross motor, fine movement, adaptability, language, and social behavior. The development quotient (DQ) was used to measure the level of total neurobehavioral development and each domain of neurobehavioral development. (3) Results: The prevalence of anemia in children aged 6-24 months was 26.45%, of which iron-deficiency anemia only accounted for 27.33%. Compared with children without anemia, those with iron-deficiency anemia had a significantly lower developmental quotient (DQ) for total neurobehavioral development and gross motor and adaptability development. The partial regression coefficients were -1.33 (95% CI -2.36, -0.29; = 0.012), -1.88 (95% CI -3.74, -0.03; = 0.047), and 1.48 (95% CI -2.92, -0.05; = 0.042), respectively. Children with non-iron-deficiency anemia had significantly lower DQ for total neurobehavioral development and gross motor and fine movement development than those without anemia. The partial regression coefficients were -0.94 (95% CI -1.64, -0.25; = 0.008), -1.25 (95% CI -2.48, -0.03; = 0.044), and -1.18 (95% CI -2.15, -0.21; = 0.017), respectively. There were no statistically significant differences in total neurobehavioral development and the five domains of neurobehavioral development between children with non-iron-deficiency and iron-deficiency anemia. The partial β values were 0.40 (95% CI -1.53, 2.33; = 0.684), 0.21 (95% CI -1.39, 1.81; = 0.795), 0.63 (95% CI -1.03, 2.28; = 0.457), 0.16 (95% CI -1.78, 2.10; = 0.871), 0.35 (95% CI -1.32, 2.01; = 0.684), and 0.34 (95% CI -0.77, 1.46; = 0.545), respectively. (4) Conclusions: Both iron-deficiency anemia and non-iron-deficiency anemia were negatively correlated with the neurobehavioral development of children. Negative correlations were found between iron-deficiency anemia and gross motor and adaptability development and between non-iron-deficiency anemia and gross motor and fine movement development.
（1）背景：贫血对儿童的生长发育有全面的不良影响。本研究分析了不同类型贫血对婴幼儿期神经行为发育的潜在影响。
（2）方法：共纳入 2601 名 6-24 月龄儿童，其父母同意参与本研究。所有儿童均进行常规血液检查和神经行为发育评估。在研究入组时，通过面对面问卷的方式对儿童的父母或其他主要照顾者进行访谈。根据血清铁蛋白、C 反应蛋白和α-1-酸性糖蛋白的水平，将贫血定义为血红蛋白＜110 g/L，并分为缺铁性贫血和非缺铁性贫血。神经行为发育采用中国儿童发展量表进行评估，分为粗大运动、精细运动、适应能力、语言和社会行为五个领域。采用发育商（DQ）衡量总神经行为发育和神经行为发育各领域的水平。
（3）结果：6-24 月龄儿童贫血的患病率为 26.45%，其中缺铁性贫血仅占 27.33%。与无贫血的儿童相比，缺铁性贫血儿童的总神经行为发育和粗大运动及适应能力发育的发育商（DQ）显著较低。偏回归系数分别为-1.33（95%CI-2.36，-0.29；=0.012）、-1.88（95%CI-3.74，-0.03；=0.047）和 1.48（95%CI-2.92，-0.05；=0.042）。非缺铁性贫血儿童的总神经行为发育和粗大运动及精细运动发育的 DQ 显著低于无贫血的儿童，偏回归系数分别为-0.94（95%CI-1.64，-0.25；=0.008）、-1.25（95%CI-2.48，-0.03；=0.044）和-1.18（95%CI-2.15，-0.21；=0.017）。非缺铁性和缺铁性贫血儿童的总神经行为发育和神经行为发育的五个领域均无统计学差异。偏β值分别为 0.40（95%CI-1.53，2.33；=0.684）、0.21（95%CI-1.39，1.81；=0.795）、0.63（95%CI-1.03，2.28；=0.457）、0.16（95%CI-1.78，2.10；=0.871）、0.35（95%CI-1.32，2.01；=0.684）和 0.34（95%CI-0.77，1.46；=0.545）。
（4）结论：缺铁性贫血和非缺铁性贫血均与儿童的神经行为发育呈负相关。缺铁性贫血与粗大运动和适应能力发育相关，非缺铁性贫血与粗大运动和精细运动发育相关。
