Nutrition and Mental Health (NUTRISAM) research group, Rovira i Virgili University, Reus, Spain; Pere Virgili Institute of Health Research (IISPV), Reus, Spain.
Nutrition and Mental Health (NUTRISAM) research group, Rovira i Virgili University, Reus, Spain; Department of Psychology, Faculty of Education Sciences and Psychology, Research Centre for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain; Serra Húnter Fellow, Department of Psychology, Faculty of Education Sciences and Psychology, Rovira i Virgili University, Tarragona, Spain.
Am J Prev Med. 2023 Sep;65(3):395-405. doi: 10.1016/j.amepre.2023.02.006. Epub 2023 Mar 9.
The effectiveness of prenatal iron supplementation improves maternal hematological outcomes, but little research has focused on child outcomes. The objective of this study was to assess whether prenatal iron supplementation adjusted to maternal needs improves children's cognitive functioning.
The analyses included a subsample of nonanemic pregnant women recruited in early pregnancy and their children aged 4 years (n=295). Data were collected between 2013 and 2017 in Tarragona (Spain). On the basis of hemoglobin levels before the 12th gestational week, women receive different iron doses: 80 vs 40 mg/d if hemoglobin is 110-130 g/L and 20 vs 40 mg/d if hemoglobin >130 g/L. Children's cognitive functioning was assessed using the Wechsler Preschool and Primary Scale of Intelligence-IV and Developmental Neuropsychological Assessment-II tests. The analyses were carried out in 2022 after the completion of the study. Multivariate regression models were performed for assessing the association between different doses of prenatal iron supplementation and children's cognitive functioning.
Taking 80 mg/d of iron was positively associated with all the scales of the Wechsler Preschool and Primary Scale of Intelligence-IV and Neuropsychological Assessment-II when mothers had initial serum ferritin <15 µg/L, but it was negatively associated with Verbal Comprehension Index, Working Memory Index, Processing Speed Index, and Vocabulary Acquisition Index from Wechsler Preschool and Primary Scale of Intelligence-IV and verbal fluency index from Neuropsychological Assessment-II when mothers showed initial serum ferritin >65 µg/L. In the other group, taking 20 mg/d of iron was positively associated with Working Memory Index, Intelligence Quotient, verbal fluency, and emotion recognition indices when women had initial serum ferritin >65 µg/L.
Prenatal iron supplementation adjusted to the maternal hemoglobin levels and baseline iron stores improves cognitive functioning in children aged 4 years.
产前铁补充可改善孕产妇血液学结局，但针对儿童结局的研究甚少。本研究旨在评估调整至孕产妇需求的产前铁补充是否可改善儿童认知功能。
该分析纳入了于孕早期招募的非贫血孕妇的亚组及其 4 岁儿童（n=295）。数据于 2013 年至 2017 年在西班牙塔拉戈纳收集。基于妊娠第 12 周前的血红蛋白水平，女性接受不同剂量的铁补充：血红蛋白在 110-130 g/L 时给予 80 与 40 mg/d，血红蛋白 >130 g/L 时给予 20 与 40 mg/d。采用韦氏学前和小学智力量表-IV 及发展神经心理评估-II 评估儿童认知功能。分析于研究完成后于 2022 年进行。采用多元回归模型评估不同剂量的产前铁补充与儿童认知功能之间的关系。
当母亲初始血清铁蛋白 <15 µg/L 时，每日补充 80 mg 铁与韦氏学前和小学智力量表-IV 的所有量表及神经心理评估-II 均呈正相关，但与韦氏学前和小学智力量表-IV 的言语理解指数、工作记忆指数、处理速度指数和词汇获取指数及神经心理评估-II 的言语流畅性指数呈负相关；当母亲初始血清铁蛋白 >65 µg/L 时，每日补充 20 mg 铁与工作记忆指数、智商、言语流畅性和情绪识别指数呈正相关。在另一组中，当女性初始血清铁蛋白 >65 µg/L 时，每日补充 20 mg 铁与工作记忆指数、智商、言语流畅性和情绪识别指数呈正相关。
根据孕产妇血红蛋白水平和基线铁储备调整的产前铁补充可改善 4 岁儿童的认知功能。
