Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China.
Department of Medical Ultrasound, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China.
Sci Rep. 2023 Feb 13;13(1):2490. doi: 10.1038/s41598-023-29690-x.
Early iron deficiency has detrimental consequences on neurodevelopment; whether male and female infants are equally susceptible to the functional outcomes of iron deficiency is unclear. This study aimed to investigate the sex differences in the association between serum ferritin levels and neurodevelopment in infants. Data for this cross-sectional study were drawn from hospital information and early childhood development program service systems at Guangdong Women and Children's Hospital, Guangzhou, China. In total, 4579 infants aged 6-12 months were included from July 2018 to March 2020. Their neurodevelopment was assessed using the Children Neuropsychological and Behavior Scale-Revision 2016. Serum ferritin levels were measured by chemiluminescence assay. The association between serum ferritin levels and neurodevelopmental delay in each domain was estimated using logistic regression models adjusted for potential confounders. The mean concentration of serum ferritin was 35.56 ± 21.57 ng/mL. Serum ferritin levels were significantly higher in female than in male infants (P < 0.001). Iron deficiency (serum ferritin levels < 12 ng/mL) was significantly more prevalent in male than in female infants (P < 0.001). Linear regression revealed a positive association between serum ferritin levels and general quotient, gross motor, fine motor, language, and adaptive behavior in females. Iron deficiency was significantly associated with an increased risk of adaptive behavior delay in females (adjusted odds ratio (OR), 2.22; 95% confidence interval (CI): 1.17-4.20). Iron deficiency anemia was associated with an increased risk of developmental delay for general quotient (adjusted OR, 4.88; 95% CI: 1.74-13.65), fine motor (adjusted OR = 2.58, 95%: CI: 1.13-5.94) and adaptive behavior (adjusted OR, 3.38; 95% CI: 1.51-7.57) among females, but not in males. Associations between serum ferritin levels and neurodevelopment in infants aged 6-12 months were sex-related. Females with iron deficiency, especially those with iron-deficiency anemia, were more susceptible to neurodevelopmental delay than males.
早期缺铁对神经发育有不利影响；男性和女性婴儿是否同样容易受到缺铁功能后果的影响尚不清楚。本研究旨在探讨血清铁蛋白水平与婴儿神经发育之间的关联是否存在性别差异。本横断面研究的数据来自中国广州广东妇女儿童医疗中心的医院信息和幼儿发展计划服务系统。共有 2018 年 7 月至 2020 年 3 月期间 4579 名 6-12 月龄婴儿纳入研究。使用儿童神经心理和行为量表-2016 修订版评估他们的神经发育情况。通过化学发光法测定血清铁蛋白水平。使用调整潜在混杂因素的逻辑回归模型估计血清铁蛋白水平与各领域神经发育延迟之间的关系。血清铁蛋白的平均浓度为 35.56 ± 21.57ng/mL。女性婴儿的血清铁蛋白水平显著高于男性婴儿（P<0.001）。男性婴儿的缺铁（血清铁蛋白水平<12ng/mL）发生率显著高于女性婴儿（P<0.001）。线性回归显示，血清铁蛋白水平与女性的总智商、大运动、精细运动、语言和适应行为呈正相关。缺铁与女性的适应行为延迟风险增加显著相关（调整后的比值比（OR），2.22；95%置信区间（CI）：1.17-4.20）。缺铁性贫血与总智商（调整后的 OR，4.88；95% CI：1.74-13.65）、精细运动（调整后的 OR=2.58，95% CI：1.13-5.94）和适应行为（调整后的 OR，3.38；95% CI：1.51-7.57）发育迟缓的风险增加有关，而在男性中则没有。6-12 月龄婴儿的血清铁蛋白水平与神经发育之间的关系存在性别差异。缺铁的女性，尤其是缺铁性贫血的女性，比男性更容易出现神经发育迟缓。
