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Early-Life Iron Deficiency Anemia Programs the Hippocampal Epigenomic Landscape. Nutrients 2021; 13:nu13113857. [PMID: 34836113 PMCID: PMC8623089 DOI: 10.3390/nu13113857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 01/04/2023] Open
Abstract
Iron deficiency (ID) anemia is the foremost micronutrient deficiency worldwide, affecting around 40% of pregnant women and young children. ID during the prenatal and early postnatal periods has a pronounced effect on neurodevelopment, resulting in long-term effects such as cognitive impairment and increased risk for neuropsychiatric disorders. Treatment of ID has been complicated as it does not always resolve the long-lasting neurodevelopmental deficits. In animal models, developmental ID results in abnormal hippocampal structure and function associated with dysregulation of genes involved in neurotransmission and synaptic plasticity. Dysregulation of these genes is a likely proximate cause of the life-long deficits that follow developmental ID. However, a direct functional link between iron and gene dysregulation has yet to be elucidated. Iron-dependent epigenetic modifications are one mechanism by which ID could alter gene expression across the lifespan. The jumonji and AT-rich interaction domain-containing (JARID) protein and the Ten-Eleven Translocation (TET) proteins are two families of iron-dependent epigenetic modifiers that play critical roles during neural development by establishing proper gene regulation during critical periods of brain development. Therefore, JARIDs and TETs can contribute to the iron-mediated epigenetic mechanisms by which early-life ID directly causes stable changes in gene regulation across the life span.
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Irritability and Perceived Expressed Emotion in Adolescents With Iron Deficiency and Iron Deficiency Anemia: A Case-Control Study. J Pediatr Hematol Oncol 2020; 42:403-409. [PMID: 31725544 DOI: 10.1097/mph.0000000000001663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to assess the difference in irritability and perceived expressed emotion (EE) between adolescents with iron deficiency (ID) or iron deficiency anemia (IDA) and their healthy peers. In addition, we aimed to investigate the relationship between hemogram parameters, irritability, and perceived EE in adolescents with ID and IDA. The sample of this single-center cross-sectional case-control study consisted of 89 adolescents from 12 to 17 years of age. Of the participants, 19 had been diagnosed with ID, 31 had IDA, and 39 were healthy controls. Significant differences in the self-reported and parent-reported irritability scores were observed between the ID group and the control group and between the IDA group and the control group. There was also a significant difference in the subscale of irritability between the ID group and the control group. The difference between the IDA and control groups in the intrusiveness subscale was found to be significant as well. Adolescents with IDA and ID exhibited significantly perceived irritability compared with the control group. In terms of irritability, adolescents with IDA and ID revealed greater irritability than their healthy peers. The results of this study suggest that irritability and perceived EE should be investigated in cases of ID, whether with or without anemia. As chronic diseases may benefit substantially from psychiatric consultation, psychosocial evaluation and intervention should be considered a complementary treatment option in the management of ID and IDA.
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East P, Delker E, Blanco E, Encina P, Lozoff B, Gahagan S. Effect of Infant Iron Deficiency on Children's Verbal Abilities: The Roles of Child Affect and Parent Unresponsiveness. Matern Child Health J 2019; 23:1240-1250. [PMID: 31228147 PMCID: PMC6714573 DOI: 10.1007/s10995-019-02764-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Infants who are iron-deficient anemic seek and receive less stimulation from their caregivers, predisposing such children to be functionally isolated. OBJECTIVES 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Patricia East
- Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, Mail Code 0927, La Jolla, CA, 92093-0927, USA.
| | - Erin Delker
- Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, Mail Code 0927, La Jolla, CA, 92093-0927, USA
| | - Estela Blanco
- Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, Mail Code 0927, La Jolla, CA, 92093-0927, USA
| | - Pamela Encina
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Betsy Lozoff
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, Mail Code 0927, La Jolla, CA, 92093-0927, USA
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Ferreira A, Neves P, Gozzelino R. Multilevel Impacts of Iron in the Brain: The Cross Talk between Neurophysiological Mechanisms, Cognition, and Social Behavior. Pharmaceuticals (Basel) 2019; 12:ph12030126. [PMID: 31470556 PMCID: PMC6789770 DOI: 10.3390/ph12030126] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 12/12/2022] Open
Abstract
Iron is a critical element for most organisms, which plays a fundamental role in the great majority of physiological processes. So much so, that disruption of iron homeostasis has severe multi-organ impacts with the brain being particularly sensitive to such modifications. More specifically, disruption of iron homeostasis in the brain can affect neurophysiological mechanisms, cognition, and social behavior, which eventually contributes to the development of a diverse set of neuro-pathologies. This article starts by exploring the mechanisms of iron action in the brain and follows with a discussion on cognitive and behavioral implications of iron deficiency and overload and how these are framed by the social context. Subsequently, we scrutinize the implications of the disruption of iron homeostasis for the onset and progression of psychosocial disorders. Lastly, we discuss the links between biological, psychological, and social dimensions and outline potential avenues of research. The study of these interactions could ultimately contribute to a broader understanding of how individuals think and act under physiological and pathophysiological conditions.
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Affiliation(s)
- Ana Ferreira
- Centro Interdisciplinar de Ciências Sociais (CICS.NOVA), Faculdade de Ciências Sociais e Humanas da Universidade NOVA de Lisboa (NOVA FCSH), 1069-061 Lisbon, Portugal
| | - Pedro Neves
- School of Business and Economics, NOVA University of Lisbon, 2775-405 Lisbon, Portugal
| | - Raffaella Gozzelino
- Chronic Diseases Research Center (CEDOC)/NOVA Medical School, Universidade NOVA de Lisboa, 1180-052, 1150-082 Lisbon, Portugal.
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Iron as a model nutrient for understanding the nutritional origins of neuropsychiatric disease. Pediatr Res 2019; 85:176-182. [PMID: 30341413 PMCID: PMC6353667 DOI: 10.1038/s41390-018-0204-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/04/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022]
Abstract
Adequate nutrition during the pre- and early-postnatal periods plays a critical role in programming early neurodevelopment. Disruption of neurodevelopment by nutritional deficiencies can result not only in lasting functional deficits, but increased risk of neuropsychiatric disease in adulthood. Historical periods of famine such as the Dutch Hunger Winter and the Chinese Famine have provided foundational evidence for the long-term effects of developmental malnutrition on neuropsychiatric outcomes. Because neurodevelopment is a complex process that consists of many nutrient- and brain-region-specific critical periods, subsequent clinical and pre-clinical studies have aimed to elucidate the specific roles of individual macro- and micronutrient deficiencies in neurodevelopment and neuropsychiatric pathologies. This review will discuss developmental iron deficiency (ID), the most common micronutrient deficiency worldwide, as a paradigm for understanding the role of early-life nutrition in neurodevelopment and risk of neuropsychiatric disease. We will review the epidemiologic data linking ID to neuropsychiatric dysfunction, as well as the underlying structural, cellular, and molecular mechanisms that are thought to underlie these lasting effects. Understanding the mechanisms driving lasting dysfunction and disease risk is critical for development and implementation of nutritional policies aimed at preventing nutritional deficiencies and their long-term sequelae.
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NOURAIE S, AMIRALIl AKBARI S, VAMEGHI R, AKBARZADE BAGHBAN A. The Effect of the Timing of Umbilical Cord Clamping on Hemoglobin Levels, Neonatal Outcomes and Developmental Status in Infants at 4 Months Old. IRANIAN JOURNAL OF CHILD NEUROLOGY 2019; 13:45-55. [PMID: 30598672 PMCID: PMC6296705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 11/11/2017] [Accepted: 01/06/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Delayed umbilical cord clamping (DCC) increases blood transfer to newborns. Hence we investigated the effect of the timing of DCC on hemoglobin levels, neonatal outcomes and developmental status in infants at four months old. MATERIALS & METHODS This clinical trial examined infants born to 400 pregnant women immediately upon birth and at the age of four months in Isfahan, central Iran in 2016. A table of random numbers was used to randomly allocate the newborns to intervention group with a 90-120-sec delay in umbilical cord clamping and the control group with a clamping delay of below 60 sec, and blood samples were taken from their umbilical cords. The Ages and Stages Questionnaire was used to evaluate the infants' developmental status. RESULTS Umbilical cord hemoglobin was significantly higher in the intervention group compared to in the controls (P=0.024). No significant differences were observed between the two groups in terms of neonatal complications except neonatal jaundice was significantly more common in the intervention group (P=0.025), although the need for phototherapy was not different between the groups. Overall, no significant differences were observed between the two groups in terms of developmental status at four months old; however, the infants had better problem-solving skills in the DCC group (P=0.015). CONCLUSION Despite elevating hemoglobin, DCC has no effects on infant development except in terms of problem-solving skills. Further studies are recommended on the effects of DCC on infant development.
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Affiliation(s)
- Soheila NOURAIE
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh AMIRALIl AKBARI
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roshanak VAMEGHI
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Alireza AKBARZADE BAGHBAN
- Proteomics Research Center, Department of Basic Sciences, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Muleviciene A, D’Amico F, Turroni S, Candela M, Jankauskiene A. Iron deficiency anemia-related gut microbiota dysbiosis in infants and young children: A pilot study. Acta Microbiol Immunol Hung 2018; 65:551-564. [PMID: 30418043 DOI: 10.1556/030.65.2018.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Nutritional iron deficiency (ID) causes not only anemia but also malfunction of the entire human organism. Recently, a role of the gut microbiota has been hypothesized, but limited data are available especially in infants. Here, we performed a pilot study to explore the gut microbiota in 10 patients with iron deficiency anemia (IDA) and 10 healthy controls aged 6-34 months. Fresh stool samples were collected from diapers, and the fecal microbiota was profiled by next-generation sequencing of the V3-V4 hypervariable region of the 16S rRNA gene. Except for diet diversity, the breastfeeding status at the enrollment, the exclusive breastfeeding duration, and the introduction of complementary foods did not differ between groups. Distinct microbial signatures were found in IDA patients, with increased relative abundance of Enterobacteriaceae (mean relative abundance, patients vs. controls, 4.4% vs. 3.0%) and Veillonellaceae (13.7% vs. 3.6%), and reduced abundance of Coriobacteriaceae (3.5% vs. 8.8%) compared to healthy controls. A decreased Bifidobacteriaceae/Enterobacteriaceae ratio was observed in IDA patients. Notwithstanding the low sample size, our data highlight microbiota dysbalance in IDA worth for further investigations, aimed at unraveling the ID impact on the microbiome trajectory in early life, and the possible long-term consequences.
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Affiliation(s)
- Audrone Muleviciene
- 1 Clinic of Children’s Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Federica D’Amico
- 2 Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Silvia Turroni
- 2 Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Marco Candela
- 2 Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Augustina Jankauskiene
- 1 Clinic of Children’s Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Robinson SL, Marín C, Oliveros H, Mora-Plazas M, Richards BJ, Lozoff B, Villamor E. Iron Deficiency, Anemia, and Low Vitamin B-12 Serostatus in Middle Childhood Are Associated with Behavior Problems in Adolescent Boys: Results from the Bogotá School Children Cohort. J Nutr 2018; 148:760-770. [PMID: 29897579 DOI: 10.1093/jn/nxy029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/14/2017] [Accepted: 01/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Iron deficiency (ID) in infancy is related to subsequent behavior problems. The effects of micronutrient status in middle childhood are uncertain. OBJECTIVE The aim of the study was to examine the associations of micronutrient status biomarkers in middle childhood with externalizing and internalizing behavior problems in adolescence. METHODS We assessed whether ID (ferritin <15 µg/L), anemia (hemoglobin <12.7 g/dL), or blood concentrations of zinc, vitamins A and B-12, and folate at ages 5-12 y were associated with externalizing or internalizing behavior problems in adolescence in 1042 schoolchildren from Bogotá, Colombia. Behavior problems were assessed with the Youth Self-Report questionnaire after a median 6.2 y of follow-up. Mean problem score differences with 95% CIs were estimated between categories of micronutrient status biomarkers with the use of multivariable linear regression. RESULTS Mean ± SD externalizing and internalizing problems scores were 52.6 ± 9.6 and 53.8 ± 9.9, respectively. Among boys, middle-childhood ID, anemia, and low plasma vitamin B-12 were associated with 5.9 (95% CI: 1.0, 10.7), 6.6 (95% CI: 1.9, 11.3), and 2.7 (95% CI: 0.4, 4.9) units higher mean externalizing problems scores in adolescence, respectively-after adjustment for baseline age, time spent watching television or playing video games, mother's height, and socioeconomic status. Also in boys, ID was related to an adjusted 6.4 (95% CI: 1.2, 11.6) units higher mean internalizing problems score. There were no associations among girls. Other micronutrient status biomarkers were not associated with behavior problems. CONCLUSIONS ID, anemia, and low vitamin B-12 in middle childhood are related to behavior problems in adolescent boys.This study was registered at clinicaltrials.gov as NCT03297970.
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Affiliation(s)
- Sonia L Robinson
- Department of Epidemiology, School of Public Health, and The Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Constanza Marín
- Medical School, Department of Medicine, The University of La Sabana, Colombia, Chía.,The Foundation for Research in Nutrition and Health, Colombia, Bogotá
| | - Henry Oliveros
- Medical School, Department of Medicine, The University of La Sabana, Colombia, Chía
| | | | - Blair J Richards
- The Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Betsy Lozoff
- The Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Eduardo Villamor
- Department of Epidemiology, School of Public Health, and The Center for Human Growth and Development, University of Michigan, Ann Arbor, MI.,The Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
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Duck KA, Neely EB, Simpson IA, Connor JR. A role for sex and a common HFE gene variant in brain iron uptake. J Cereb Blood Flow Metab 2018; 38:540-548. [PMID: 28350201 PMCID: PMC5851144 DOI: 10.1177/0271678x17701949] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/23/2017] [Accepted: 03/07/2017] [Indexed: 11/16/2022]
Abstract
HFE (high iron) is an essential protein for regulating iron transport into cells. Mutations of the HFE gene result in loss of this regulation causing accumulation of iron within the cell. The mutated protein has been found increasingly in numerous neurodegenerative disorders in which increased levels of iron in the brain are reported. Additionally, evidence that these mutations are associated with elevated brain iron challenges the paradigm that the brain is protected by the blood-brain barrier. While much has been studied regarding the role of HFE in cellular iron uptake, it has remained unclear what role the protein plays in the transport of iron into the brain. We investigated regulation of iron transport into the brain using a mouse model with a mutation in the HFE gene. We demonstrated that the rate of radiolabeled iron (59Fe) uptake was similar between the two genotypes despite higher brain iron concentrations in the mutant. However, there were significant differences in iron uptake between males and females regardless of genotype. These data indicate that brain iron status is consistently maintained and tightly regulated at the level of the blood-brain barrier.
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Affiliation(s)
- Kari A Duck
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Elizabeth B Neely
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Ian A Simpson
- Department of Neural and Behavioral Sciences, Penn State Hershey Medical Center, Hershey, PA, USA
| | - James R Connor
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, USA
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10
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Santos DCC, Angulo-Barroso RM, Li M, Bian Y, Sturza J, Richards B, Lozoff B. Timing, duration, and severity of iron deficiency in early development and motor outcomes at 9 months. Eur J Clin Nutr 2018; 72:332-341. [PMID: 29235557 PMCID: PMC5843498 DOI: 10.1038/s41430-017-0015-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/22/2017] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Poorer motor development is reported in infants with iron deficiency (ID). The role of timing, duration and severity is unclear. We assessed relations between ID timing, duration, and severity and gross motor scores, neurological integrity, and motor behavior quality at 9 months. SUBJECTS/METHODS Iron status was determined at birth and 9 months in otherwise healthy term Chinese infants. The 9-month motor evaluation included the Peabody Developmental Motor Scale (PDMS-2), Infant Neurological International Battery (INFANIB), and motor quality factor. Motor outcomes were analyzed by ID timing (fetal-neonatal, infancy), duration, and severity. For severity, we also considered maternal iron status. RESULTS The data were available for 1194 infants. Iron status was classified as fetal-neonatal and infancy ID (n = 253), fetal-neonatal ID (n = 256), infancy ID (n = 288), and not ID (n = 397). Compared with not ID, infants with fetal-neonatal or infancy ID had lower locomotion scores (effect size ds = 0.19, 0.18) and those with ID in both periods (longer duration) had lower locomotion and overall PDMS-2 gross motor scores (ds = 0.20, 0.18); ID groups did not differ. More severe ID in late pregnancy was associated with lower INFANIB Vestibular function (p = 0.01), and total score (p = 0.03). More severe ID in infancy was associated with lower scores for locomotion (p = 0.03), overall gross motor (p = 0.05). CONCLUSIONS Fetal-neonatal and/or infancy ID was associated with lower overall gross motor development and locomotion test scores at 9 months. Associations with ID severity varied by ID timing: more severe ID in late pregnancy, poorer neurological integrity; more severe ID in infancy, poorer gross motor development.
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Affiliation(s)
- Denise C C Santos
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, 48109-5406, USA
- Human Movement Sciences Graduate Program, Methodist University of Piracicaba, Piracicaba, SP, Brazil
| | - Rosa M Angulo-Barroso
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, 48109-5406, USA.
- Department of Kinesiology, California State University, Northridge, CA, 91330-8287, USA.
| | - Ming Li
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yang Bian
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, 48109-5406, USA
| | - Blair Richards
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, 48109-5406, USA
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, 48109-5406, USA
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, 48109-5718, USA
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East P, Lozoff B, Blanco E, Delker E, Delva J, Encina P, Gahagan S. Infant iron deficiency, child affect, and maternal unresponsiveness: Testing the long-term effects of functional isolation. Dev Psychol 2017; 53:2233-2244. [PMID: 28933876 DOI: 10.1037/dev0000385] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Children who are iron deficient (ID) or iron-deficient anemic (IDA) have been shown to seek and receive less stimulation from their caregivers, contributing to functional isolation. Over time, the reduced interactions between child and caregiver are thought to interfere with the acquisition of normative social competencies and adversely affect the child's development. The current study examined functional isolation in children who were ID or IDA in infancy in relation to social difficulties in middle childhood and problem behaviors in adolescence. Using a sample of 873 Chilean children, 45% of whom were ID or IDA in infancy, structural equation modeling results indicated that infant IDA was associated with children's dull affect and social reticence at age 5, which were related to mothers' unresponsiveness and understimulation. Mothers' limited responsiveness and stimulation were, in turn, related to children's peer rejection at age 10, which further linked to problem behaviors and associating with deviant peers at adolescence. Findings support the functional isolation hypothesis and suggest that early limited caregiver responsiveness and stimulation contribute to long-term social difficulties in adolescents who were iron-deficient anemic in infancy. (PsycINFO Database Record
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Affiliation(s)
- Patricia East
- Department of Pediatrics, University of California, San Diego
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan
| | - Estela Blanco
- Department of Pediatrics, University of California, San Diego
| | - Erin Delker
- Department of Pediatrics, University of California, San Diego
| | - Jorge Delva
- School of Social Work, University of Michigan
| | - Pamela Encina
- Institute of Nutrition and Food Technology, University of Chile
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego
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12
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Sajedi F, Doulabi MA, Vameghi R, Baghban AA, Mazaheri MA, Mahmodi Z, Ghasemi E. Development of Children in Iran: A Systematic Review and Meta-Analysis. Glob J Health Sci 2016; 8:51251. [PMID: 27045395 PMCID: PMC5016360 DOI: 10.5539/gjhs.v8n8p145] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/13/2015] [Indexed: 11/17/2022] Open
Abstract
Background: In order to gain a better perspective of the developmental status of children in different regions of Iran, this study was carried out to determine the prevalence and the factors impacting child development in Iranian studies. Materials and Methods: Articles published in Iranian and international journals indexed in the SID, PubMed, Scopus and Magiran databases from 2001-2015 were systematically reviewed using standard and sensitive keywords. After evaluating the quality of 155 articles in the initial search, 26 articles were analyzed according to the inclusion criteria. After investigations, meta-analysis was done for six studies and the results were combined using Random Effects model, and the heterogeneity of studies was evaluated using the I2 index. Data analysis was performed using STATA version 11.2. Results: Eagger & Beggs tests, respectively with 0/273 & 0/260 did not confirm the probability of publication bias in the data, but heterogeneity in studies was confirmed (p<0/001). On such basis, the pooled prevalence of developmental disorder based on Random Effect model was calculated to be 0.146, CI (0/107-0/184). The prevalence of developmental disorders in children in the studies reviewed was reported between 7 to 22.4%. The most important risk factors were in SES (Socio Economic Status) and Prenatal, Perinatal, Neonatal &Child groups. Conclusion: More extensive studies and early intervention with respect to causes of developmental delay in children seems necessary.
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Affiliation(s)
- Firoozeh Sajedi
- Professor of Pediatrics; Pediatric Neurorehabilitation Research Center, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran.
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13
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Su J, Cui N, Zhou G, Ai Y, Sun G, Zhao SR, Liu J. Hemoglobin Status and Externalizing Behavioral Problems in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080758. [PMID: 27472352 PMCID: PMC4997444 DOI: 10.3390/ijerph13080758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/07/2016] [Accepted: 07/22/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Still considered one of the most prevalent nutritional problems in the world, anemia has been shown in many studies to have deleterious effects on neurobehavioral development. While most research efforts have focused on investigating the effects of anemia on social and emotional development of infants by using a cross-sectional design, research is still needed to investigate whether early childhood anemia, beyond infantile years, is linked with behavioral problems. OBJECTIVE This study assessed whether (1) hemoglobin (Hb) levels in early childhood are associated with externalizing behavior; and (2) this relationship is confounded by social adversity. METHODS Hemoglobin levels were taken from children (N = 98) of the China Jintan Cohort Study at age 4 years, and externalizing behaviors (attention and aggression) were assessed with the Child Behavior Checklist (ASEBA-CBCL) at age 6 years (mean age 5.77 ± 0.39 years old). RESULTS Compared with other children in the sample, children with relatively lower Hb levels at age 4 had more behavioral problems in both attention and aggression at age 6, independent of social adversity. For boys, this association was significant for attention problems, which did not interact with social adversity. For girls, the association was significant for aggression, which interacted with social adversity. While girls on average exhibited higher social adversity than boys, the main effect of Hb was only significant in girls with low social adversity. CONCLUSIONS These results indicate that there is an inverse association between hemoglobin levels and later behavioral problems. Findings of this study suggest that regular monitoring of children's hemoglobin levels and appropriate intervention may help with early identification of behavioral problems.
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Affiliation(s)
- Jianhua Su
- Department of Neurology, The Jintan Hospital Affiliated to Jiangsu University, 16 Nanmen Street, Jintan, Changzhou 213200, China.
| | - Naixue Cui
- Schools of Nursing and Medicine, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA 19104, USA.
| | - Guoping Zhou
- Department of Neurology, The Jintan Hospital Affiliated to Jiangsu University, 16 Nanmen Street, Jintan, Changzhou 213200, China.
| | - Yuexian Ai
- Department of Neurology, The Jintan Hospital Affiliated to Jiangsu University, 16 Nanmen Street, Jintan, Changzhou 213200, China.
| | - Guiju Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Room #508, 87, DingJiaqiao, Nanjing 210096, China.
| | - Sophie R Zhao
- Schools of Nursing and Medicine, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA 19104, USA.
| | - Jianghong Liu
- Schools of Nursing and Medicine, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA 19104, USA.
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Tran PV, Kennedy BC, Pisansky MT, Won KJ, Gewirtz JC, Simmons RA, Georgieff MK. Prenatal Choline Supplementation Diminishes Early-Life Iron Deficiency-Induced Reprogramming of Molecular Networks Associated with Behavioral Abnormalities in the Adult Rat Hippocampus. J Nutr 2016; 146:484-93. [PMID: 26865644 PMCID: PMC4763487 DOI: 10.3945/jn.115.227561] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 01/05/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Early-life iron deficiency is a common nutrient deficiency worldwide. Maternal iron deficiency increases the risk of schizophrenia and autism in the offspring. Postnatal iron deficiency in young children results in cognitive and socioemotional abnormalities in adulthood despite iron treatment. The rat model of diet-induced fetal-neonatal iron deficiency recapitulates the observed neurobehavioral deficits. OBJECTIVES We sought to establish molecular underpinnings for the persistent psychopathologic effects of early-life iron deficiency by determining whether it permanently reprograms the hippocampal transcriptome. We also assessed the effects of maternal dietary choline supplementation on the offspring's hippocampal transcriptome to identify pathways through which choline mitigates the emergence of long-term cognitive deficits. METHODS Male rat pups were made iron deficient (ID) by providing pregnant and nursing dams an ID diet (4 g Fe/kg) from gestational day (G) 2 through postnatal day (PND) 7 and an iron-sufficient (IS) diet (200 g Fe/kg) thereafter. Control pups were provided IS diet throughout. Choline (5 g/kg) was given to half the pregnant dams in each group from G11 to G18. PND65 hippocampal transcriptomes were assayed by next generation sequencing (NGS) and analyzed with the use of knowledge-based Ingenuity Pathway Analysis. Real-time polymerase chain reaction was performed to validate a subset of altered genes. RESULTS Formerly ID rats had altered hippocampal expression of 619 from >10,000 gene loci sequenced by NGS, many of which map onto molecular networks implicated in psychological disorders, including anxiety, autism, and schizophrenia. There were significant interactions between iron status and prenatal choline treatment in influencing gene expression. Choline supplementation reduced the effects of iron deficiency, including those on gene networks associated with autism and schizophrenia. CONCLUSIONS Fetal-neonatal iron deficiency reprograms molecular networks associated with the pathogenesis of neurologic and psychological disorders in adult rats. The positive response to prenatal choline represents a potential adjunctive therapeutic supplement to the high-risk group.
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Affiliation(s)
| | | | | | - Kyoung-Jae Won
- Institute for Diabetes, Obesity and Metabolism, Department of Genetics, and
| | - Jonathan C Gewirtz
- Graduate Program in Neuroscience, and,Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Rebecca A Simmons
- Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA
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Erdogan F, Eliaçık M, Senkal E, Erdur SK, Kulak K, Ipek IO. Evaluation of the effects of serum iron levels on lacrimal gland secretion. Kaohsiung J Med Sci 2015; 31:426-31. [DOI: 10.1016/j.kjms.2015.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 05/04/2015] [Accepted: 05/06/2015] [Indexed: 11/30/2022] Open
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16
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Chen N, Deater-Deckard K, Bell MA. The role of temperament by family environment interactions in child maladjustment. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 42:1251-62. [PMID: 24691836 DOI: 10.1007/s10802-014-9872-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In order to advance our understanding of the etiology of individual differences in child maladjustment (i.e., conduct and emotional problems), we tested hypotheses about the statistical interactions between child temperament and two aspects of the family environment: maternal negativity and positivity, and household chaos (e.g., crowding, noise, lack of routines). Mothers (n = 149) reported on their child's effortful control, negative affect, surgency, and behavioral/emotional problems. The age range of the children was 3 to 7 years old and half of the sample was girls. Observers rated maternal negativity and positivity based on brief structured interaction tasks in the laboratory. Child temperament moderated the association between maternal negativity/positivity and child maladjustment. Maternal negativity and child problem behavior were associated only for those children who also were high in surgency or negative affectivity. Maternal positivity was associated with less child problem behavior for those high in surgency. Child effortful control interacted with both maternal negativity and chaos. Maternal negativity and child problem behavior were most strongly associated for children who were low in effortful control and living in chaotic homes. The results point to distinct transactions between child temperament and maternal negativity/positivity that depend in part on the dimensions of temperament and parenting behavior in question.
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Affiliation(s)
- Nan Chen
- Department of Psychology, Virginia Tech, 109 Williams Hall (0436), Blacksburg, VA, 24061, USA
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17
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Surkan PJ, Charles MK, Katz J, Siegel EH, Khatry SK, LeClerq SC, Stoltzfus RJ, Tielsch JM. The role of zinc and iron-folic acid supplementation on early child temperament and eating behaviors in rural Nepal: a randomized controlled trial. PLoS One 2015; 10:e0114266. [PMID: 25821959 PMCID: PMC4379028 DOI: 10.1371/journal.pone.0114266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 10/31/2014] [Indexed: 11/18/2022] Open
Abstract
Child eating behaviors play an important role in nutrient intake, ultimately affecting child growth and later outcomes in adulthood. The study assessed the effects of iron-folic acid and zinc supplementation on child temperament and child eating behaviors in rural Nepal. Children (N = 569) aged 4–17 months in Sarlahi district, southern Nepal were randomized to receive daily supplements of placebo, iron-folic acid, zinc, or zinc plus iron-folic acid and followed for approximately 1 year. At baseline and four follow-up visits mothers completed questionnaires including information on demographic characteristics and child temperament and eating behaviors. The main effects of zinc and iron-folic acid supplementation on temperament and eating behaviors were assessed through crude and adjusted differences in mean cumulative score changes between visits 1 and 5. The adjusted rate-of-change for these outcomes was modeled using generalized estimating equations. Mean changes in temperament scores and in eating behavior scores between visits 1 and 5 were not significant in either the zinc or non-zinc group. Children in the iron-folic acid group increased temperament scores by 0.37 points over 5 visits (95% CI 0.02, 0.7), which was not significant after adjustment. Neither the adjusted rate-of-change in temperament scores between zinc and non-zinc (β = −0.03, 95% CI −0.3, 0.2) or iron-folic acid and non-iron-folic acid (β = 0.08, 95% CI −0.2, 0.3) were significantly different. Adjusted rate of change analysis showed no significant difference between zinc and non-zinc (β = −0.14, 95% CI −0.3, 0.04) or between iron and non-iron eating behavior scores (β = −0.11, 95% CI −0.3, 0.1). Only among children with iron-deficiency anemia at baseline was there a significant decrease in eating behavior score, indicating better eating behaviors, when supplemented with zinc (β = −0.3, 95% CI −0.6, −0.01), Ultimately, this effect of zinc on eating behaviors was the only effect we observed after approximately one year of micronutrient supplementation.
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Affiliation(s)
- Pamela J. Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Mary Katherine Charles
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Emily H. Siegel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Subarna K. Khatry
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Nepal Nutrition Intervention Project—Sarlahi (NNIP-S), Hariaun, Nepal
| | - Steven C. LeClerq
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Nepal Nutrition Intervention Project—Sarlahi (NNIP-S), Hariaun, Nepal
| | - Rebecca J. Stoltzfus
- Nepal Nutrition Intervention Project—Sarlahi (NNIP-S), Hariaun, Nepal
- Division of Nutritional Sciences, Program in International Nutrition, Cornell University, Ithaca, New York, United States of America
| | - James M. Tielsch
- George Washington University, School of Public Health, Washington, District of Columbia, United States of America
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Atzaba-Poria N, Deater-Deckard K, Bell MA. It takes more than one for parenting: How do maternal temperament and child's conduct problems relate to maternal parenting behavior? PERSONALITY AND INDIVIDUAL DIFFERENCES 2014; 69:81-86. [PMID: 25089066 DOI: 10.1016/j.paid.2014.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The current study examined how individual differences in maternal temperament and child problem behaviors correlate with observed maternal positivity and negativity toward the child. The sample consisted of 153 mothers of 3-to-7 year old children. Mothers reported their own temperament (surgency, orienting sensitivity, effortful control and negative affect) and their children's problem behaviors. Maternal behavior was videotaped in a set of structured interaction tasks with the child during a lab visit. Results indicated that children's problem behaviors were related to less maternal positivity and more negativity. In addition, observed maternal negativity was associated with less maternal effortful control and more negative affect. In contrast, maternal temperament was unrelated to observed maternal positivity toward the child. Furthermore, maternal temperament was related to mothers' positivity and negativity but only for children high in problem behaviors. The findings implicate that child problem behaviors may interact with maternal temperament in explaining variance in caregiving positivity and negativity.
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Affiliation(s)
- Naama Atzaba-Poria
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Kirby Deater-Deckard
- Department of Psychology, Virginia Tech, 109 Williams Hall (0436), Blacksburg, VA 24061
| | - Martha Ann Bell
- Department of Psychology, Virginia Tech, 109 Williams Hall (0436), Blacksburg, VA 24061
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Striking while the iron is hot: Understanding the biological and neurodevelopmental effects of iron deficiency to optimize intervention in early childhood. CURRENT PEDIATRICS REPORTS 2014; 2:291-298. [PMID: 25512881 DOI: 10.1007/s40124-014-0058-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Prenatal and early postnatal iron deficiency (ID) is associated with long-term neurobiological alterations and disruptions in cognitive, social, and behavioral development. Early life ID is particularly detrimental as this is a period of rapid neurodevelopment. Even after iron supplementation, cognitive and social disruptions often persist in formerly iron deficient individuals. Observational studies of the acute and long-term effects of early life ID yield different results based on the timing of ID. Further, intervention studies demonstrate some improvement for certain domains but still show residual effects years later, which are dependent on the timing of ID and treatment. This review will cover the effects of ID during infancy and early childhood on brain structure and function, cognition, and behavior in relation to preclinical models of ID and sensitive periods of human brain development.
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Affiliation(s)
- Elizabeth L Prado
- Department of Nutrition; University of California at Davis; Davis CA USA
- SUMMIT Institute of Development; Mataram Nusa Tenggara Barat Indonesia
| | - Kathryn G Dewey
- Department of Nutrition; University of California at Davis; Davis CA USA
- SUMMIT Institute of Development; Mataram Nusa Tenggara Barat Indonesia
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21
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Harvey L, Boksa P. Do prenatal immune activation and maternal iron deficiency interact to affect neurodevelopment and early behavior in rat offspring? Brain Behav Immun 2014; 35:144-54. [PMID: 24064370 DOI: 10.1016/j.bbi.2013.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 08/27/2013] [Accepted: 09/12/2013] [Indexed: 11/17/2022] Open
Abstract
Infection and iron deficiency are common during pregnancy and studies have described altered brain development in the offspring as a result of these individual maternal exposures. Both exposures have been identified as risk factors for schizophrenia yet they have never been modeled simultaneously. We developed a rat model of prenatal immune activation on a background of maternal iron deficiency to determine whether these factors interact to affect neurodevelopment and early behavior in offspring. Pregnant rats were placed on iron sufficient (IS) or iron deficient (ID) diets from E2 to P7, and administered LPS or saline on E15/16. Iron was reduced in liver, spleen, serum and placenta from ID dams by E15. LPS administration on E15 caused greater induction of serum interleukin-6 and tumor necrosis factor-α in ID dams compared to IS dams. Offspring (P0, P7) from ID dams had reduced iron in spleen, liver and brain compared to IS, which normalized by P21. Pups from ID dams showed differences in forelimb grasp and acoustic startle, whilst pups from LPS dams displayed differences in grip ability, geotaxis reflex, cliff avoidance and acoustic startle. Offspring from LPS dams displayed reduced locomotor activity at P7 and P60; offspring from ID dams showed no change. Our findings show effects of prenatal LPS and maternal iron deficiency were additive, such that offspring exposed to both insults displayed more neurodevelopmental abnormalities than offspring exposed to one alone. Yet surprisingly there was no interaction between factors, suggesting independent mechanisms of action.
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Affiliation(s)
- Louise Harvey
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute, 6875 La Salle Blvd, Verdun, H4H 1R3 Quebec, Canada
| | - Patricia Boksa
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute, 6875 La Salle Blvd, Verdun, H4H 1R3 Quebec, Canada.
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Park S. Relationship between Preschool Child-Mother Interaction, Child's Health Status, Health-Related Quality of Life, and Social Development. CHILD HEALTH NURSING RESEARCH 2014. [DOI: 10.4094/chnr.2014.20.4.255] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sunghee Park
- Department of Nursing, Kunsan National University, Gunsan, Korea
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23
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Wang Z, Deater-Deckard K, Bell MA. Household chaos moderates the link between maternal attribution bias and parenting: Parenting: Science and Practice. PARENTING, SCIENCE AND PRACTICE 2013; 13:10.1080/15295192.2013.832569. [PMID: 24358017 PMCID: PMC3864824 DOI: 10.1080/15295192.2013.832569] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Parents who attribute child misbehavior to children's intentions and dismiss situational factors tend to show more hostility and less warmth in their parenting behavior, and are at greater risk for maltreatment. We extended this literature by investigating the role of household chaos as a moderator of the link between maternal attribution biases and parenting behaviors. DESIGN The current sample included 160 mothers of 3- to7-year-old children. Mothers provided reports on their attribution biases and household chaos levels. Maternal negativity and positivity were measured using self-reports and observers' ratings. RESULTS The links between attribution bias and parenting behavior were stronger in more chaotic environments, with the moderating effect of chaos being particularly strong for internal attribution bias. CONCLUSIONS The findings point to the importance of social cognitive biases in the etiology of maternal behavior in family contexts that lack order and predictability.
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Affiliation(s)
- Z Wang
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall (0436), Blacksburg, VA, 24061. Zhe Wang and Martha Ann Bell are also at Virginia Tech
| | - K Deater-Deckard
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall (0436), Blacksburg, VA, 24061. Zhe Wang and Martha Ann Bell are also at Virginia Tech
| | - M A Bell
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall (0436), Blacksburg, VA, 24061. Zhe Wang and Martha Ann Bell are also at Virginia Tech
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Abstract
Human infancy has been studied as a platform for hypothesis and theory testing, as a major physiological and psychological adjustment, as an object of adults' effects as well as a source of effects on adults, for its comparative value, as a stage of life, and as a setting point for the life course. Following an orientation to infancy studies, including previous reviews and a discussion of the special challenges infants pose to research, this article focuses on infancy as a foundation and catalyst of human development in the balance of the life course. Studies of stability and prediction from infancy illustrate the depth and complexity of modern research on infants and provide a long-awaited reply to key philosophical and practical questions about the meaningfulness and significance of infancy.
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Affiliation(s)
- Marc H Bornstein
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service, Bethesda, Maryland 20892;
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25
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Gottfried RJ, Gerring JP, Machell K, Yenokyan G, Riddle MA. The iron status of children and youth in a community mental health clinic is lower than that of a national sample. J Child Adolesc Psychopharmacol 2013; 23:91-100. [PMID: 23480325 PMCID: PMC3609602 DOI: 10.1089/cap.2012.0001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Iron plays a key role in brain function, and a deficiency of iron has been implicated in various cognitive, motor, and psychiatric disorders. Because of recent evidence that iron deficiency may be related to attention-deficit/hyperactivity disorder (ADHD) and other psychiatric disorders, the goal of this study was to compare the iron status of children and youth seen in a community mental health clinic with a national sample of same-aged subjects. METHODS In this study, a consecutive series of 108 patients (79 males) referred to a community mental health clinic was compared with a National Health and Nutrition Examination Survey (NHANES) sample on measures of iron status. Wilcoxon sign rank and median tests were used to compare distributions of ferritin. Quantile regression was performed to compare the ferritin level in the two samples while adjusting for demographic differences. Chi squared (χ2) was used to compare rates of low hemoglobin in the two samples. RESULTS The iron status of the clinic sample, as measured by ferritin levels (median=23 μg/L), was significantly lower than that of the national sample (median=43 μg/L). After adjustment for age, gender, and race, the clinic sample was found to have 19.2 μg/L lower ferritin than the national sample (95% CI from 7.6 to 30.9, p value=0.001). There were also significantly more subjects in the clinic sample with low hemoglobin than in the national sample. There were no differences in ferritin levels between those patients in the clinic sample with and without an ADHD or other specific psychiatric diagnosis. CONCLUSIONS The ferritin levels of children and youth in a mental health clinic sample were significantly lower than those of the same-aged subjects in a national sample. Therefore, compromised iron status may be an additional biological risk factor for cognitive, behavioral, and psychiatric problems in pediatric populations served by the community mental health clinic.
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Affiliation(s)
| | - Joan P. Gerring
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kyla Machell
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gayane Yenokyan
- Johns Hopkins University School of Public Health, Baltimore, Maryland
| | - Mark A. Riddle
- Johns Hopkins University School of Medicine, Baltimore, Maryland
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Torres-Vega A, Pliego-Rivero BF, Otero-Ojeda GA, Gómez-Oliván LM, Vieyra-Reyes P. Limbic system pathologies associated with deficiencies and excesses of the trace elements iron, zinc, copper, and selenium. Nutr Rev 2012. [PMID: 23206282 DOI: 10.1111/j.1753-4887.2012.00521.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Deficiencies of nutrients such as amino acids, vitamins, lipids, and trace elements during gestation and early infanthood have strong deleterious effects on the development of the limbic system; these effects may be irreversible, even when adequate supplementation is provided at later developmental stages. Recent advances in the neurochemistry of biometals are increasingly establishing the roles of the trace elements iron, copper, zinc, and selenium in a variety of cell functions and are providing insight into the repercussions of deficiencies and excesses of these elements on the development of the central nervous system, especially the limbic system. The limbic system comprises diverse areas with high metabolic demands and differential storage of iron, copper, zinc, and selenium. This review summarizes available evidence suggesting the involvement of these trace elements in pathological disorders of the limbic system.
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Affiliation(s)
- Adriana Torres-Vega
- Neurofisiología de la Conducta, Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, Estado de México, Mexico
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Aubuchon-Endsley NL, Grant SL, Thomas DG, Kennedy TS, Berhanu G, Stoecker BJ, Hubbs-Tait L, Hambidge KM. Infant responsiveness, alertness, haemoglobin and growth in rural Sidama, Ethiopia. MATERNAL AND CHILD NUTRITION 2012; 9:483-98. [PMID: 22233352 DOI: 10.1111/j.1740-8709.2011.00391.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several recent studies have supported relations between infant behaviour (alertness and responsiveness) and nutrition in addition to investigating infant behaviour within the context of changes in iron status over time. Existing research is typically limited to the investigation of the effects of a single vitamin or mineral, and no studies have been found that examined the influence that early alertness and responsiveness have on growth in early infancy, despite the fact that relations between behaviour and nutritional status may be bidirectional. The current study used a sample of Ethiopian infants and investigated anthropometrics, haemoglobin, the frequency of alertness and the frequency of responsiveness at 6 and 9 months of age. Six-month weight-for-age predicted 9-month frequency of alertness, while 6-month haemoglobin predicted 9-month frequency of responsiveness. Compared with responsive infants, non-responsive infants at 6 months remained more non-responsive at 9 months, although weight-for-age for both groups converged at 9 months. Results support relations between nutrition and behaviour (alertness and responsiveness) and provide evidence of a potentially useful tool (the Laboratory Temperament Assessment Battery) that was adapted to evaluate these relations in Ethiopia.
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Affiliation(s)
- Nicki L Aubuchon-Endsley
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA Institute of Nutrition, Food Science, and Technologies, Hawassa University, Awassa, Ethiopia Department of Human Development & Family Science, Oklahoma State University, Stillwater, Oklahoma, USA Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA
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Chang S, Wang L, Wang Y, Brouwer ID, Kok FJ, Lozoff B, Chen C. Iron-deficiency anemia in infancy and social emotional development in preschool-aged Chinese children. Pediatrics 2011; 127:e927-33. [PMID: 21402624 DOI: 10.1542/peds.2010-1659] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We aimed to compare affect and behavior of 3 groups of nonanemic 4-year-old children: children with iron-deficiency anemia (IDA) in infancy whose anemia was not corrected before 24 months (chronic IDA) (n = 27); children with IDA in infancy whose anemia was corrected before 24 months (corrected IDA) (n = 70); and children who were nonanemic in infancy and at 24 months (n = 64). METHOD Mother and child dyads were invited to a local clinic room. Children's social referencing, wariness, frustration-tolerance behavior, and affect were observed during a set of situations encountered in the laboratory, including free play, stranger approach, novel toy, and delay of gratification. The whole procedure was videotaped. The children's affective and behavioral displays were coded by using a time-sampling (5-second segments) code scheme. Iron status of children was determined on the basis of hemoglobin concentration measured with the cyanomethemoglobin method in blood samples obtained by fingerstick in infancy and at the ages of 24 months and 4 years. RESULTS Children who had chronic IDA in infancy displayed less positive affect, less frustration tolerance, more passive behavior, and more physical self-soothing in the stranger approach and delay of gratification. In contrast, the behavior and affect of children whose anemia was corrected before the age of 24 months were comparable to those of children who were nonanemic throughout infancy. CONCLUSION The results point to the potential benefits of preventing iron deficiency in infancy and treating it before it becomes chronic or severe.
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Affiliation(s)
- Suying Chang
- Chinese Centers for Disease Control and Prevention, Beijing, China
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Lozoff B. Early iron deficiency has brain and behavior effects consistent with dopaminergic dysfunction. J Nutr 2011; 141:740S-746S. [PMID: 21346104 PMCID: PMC3056585 DOI: 10.3945/jn.110.131169] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
To honor the late John Beard's many contributions regarding iron and dopamine biology, this review focuses on recent human studies that test specific hypotheses about effects of early iron deficiency on dopamine system functioning. Short- and long-term alterations associated with iron deficiency in infancy can be related to major dopamine pathways (mesocortical, mesolimbic, nigrostriatal, tuberohypophyseal). Children and young adults who had iron deficiency anemia in infancy show poorer inhibitory control and executive functioning as assessed by neurocognitive tasks where pharmacologic and neuroimaging studies implicate frontal-striatal circuits and the mesocortical dopamine pathway. Alterations in the mesolimbic pathway, where dopamine plays a major role in behavioral activation and inhibition, positive affect, and inherent reward, may help explain altered social-emotional behavior in iron-deficient infants, specifically wariness and hesitance, lack of positive affect, diminished social engagement, etc. Poorer motor sequencing and bimanual coordination and lower spontaneous eye blink rate in iron-deficient anemic infants are consistent with impaired function in the nigrostriatal pathway. Short- and long-term changes in serum prolactin point to dopamine dysfunction in the tuberohypophyseal pathway. These hypothesis-driven findings support the adverse effects of early iron deficiency on dopamine biology. Iron deficiency also has other effects, specifically on other neurotransmitters, myelination, dendritogenesis, neurometabolism in hippocampus and striatum, gene and protein profiles, and associated behaviors. The persistence of poorer cognitive, motor, affective, and sensory system functioning highlights the need to prevent iron deficiency in infancy and to find interventions that lessen the long-term effects of this widespread nutrient disorder.
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Affiliation(s)
- Betsy Lozoff
- Center for Human Growth and Development and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI 48109, USA.
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Mihaila C, Schramm J, Strathmann FG, Lee DL, Gelein RM, Luebke AE, Mayer-Pröschel M. Identifying a window of vulnerability during fetal development in a maternal iron restriction model. PLoS One 2011; 6:e17483. [PMID: 21423661 PMCID: PMC3057971 DOI: 10.1371/journal.pone.0017483] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 02/07/2011] [Indexed: 11/19/2022] Open
Abstract
It is well acknowledged from observations in humans that iron deficiency during pregnancy can be associated with a number of developmental problems in the newborn and developing child. Due to the obvious limitations of human studies, the stage during gestation at which maternal iron deficiency causes an apparent impairment in the offspring remains elusive. In order to begin to understand the time window(s) during pregnancy that is/are especially susceptible to suboptimal iron levels, which may result in negative effects on the development of the fetus, we developed a rat model in which we were able to manipulate and monitor the dietary iron intake during specific stages of pregnancy and analyzed the developing fetuses. We established four different dietary-feeding protocols that were designed to render the fetuses iron deficient at different gestational stages. Based on a functional analysis that employed Auditory Brainstem Response measurements, we found that maternal iron restriction initiated prior to conception and during the first trimester were associated with profound changes in the developing fetus compared to iron restriction initiated later in pregnancy. We also showed that the presence of iron deficiency anemia, low body weight, and changes in core body temperature were not defining factors in the establishment of neural impairment in the rodent offspring.Our data may have significant relevance for understanding the impact of suboptimal iron levels during pregnancy not only on the mother but also on the developing fetus and hence might lead to a more informed timing of iron supplementation during pregnancy.
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Affiliation(s)
- Camelia Mihaila
- Department of Biomedical Genetics, University of Rochester, Rochester, New York, United States of America
| | - Jordan Schramm
- Department of Neurobiology and Anatomy, University of Rochester, Rochester, New York, United States of America
| | - Frederick G. Strathmann
- Department of Biomedical Genetics, University of Rochester, Rochester, New York, United States of America
| | - Dawn L. Lee
- Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, New York, United States of America
| | - Robert M. Gelein
- Department of Environmental Medicine, University of Rochester, Rochester, New York, United States of America
| | - Anne E. Luebke
- Department of Neurobiology and Anatomy, University of Rochester, Rochester, New York, United States of America
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, United States of America
- * E-mail: (MM-P); (AEL)
| | - Margot Mayer-Pröschel
- Department of Biomedical Genetics, University of Rochester, Rochester, New York, United States of America
- Department of Neurobiology and Anatomy, University of Rochester, Rochester, New York, United States of America
- * E-mail: (MM-P); (AEL)
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Caulfield LE, Zavaleta N, Chen P, Lazarte F, Albornoz C, Putnick DL, Bornstein MH, DiPietro JA. Maternal zinc supplementation during pregnancy affects autonomic function of Peruvian children assessed at 54 months of age. J Nutr 2011; 141:327-32. [PMID: 21178078 PMCID: PMC3021453 DOI: 10.3945/jn.110.128843] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 08/20/2010] [Accepted: 11/23/2010] [Indexed: 11/14/2022] Open
Abstract
Maternal prenatal zinc supplementation improved fetal autonomic regulation in a nutrient-deficient population in Peru. To evaluate whether differences in autonomic regulation existed in early childhood, we studied 165 children from a zinc supplementation trial (80% of original sample) as part of a comprehensive evaluation at age 54 mo. Electrocardiogram (ECG) data were collected from the children at rest and while they underwent a cognitive testing battery following a standardized protocol. Of these, 79 were born to mothers receiving 25 mg/d zinc in addition to 60 mg/d iron and 250 μg/d folic acid during pregnancy, and 86 were born to mothers receiving iron and folic acid only. Derived cardiac measures included heart period (HP), range, HP variability (HPV), mean square of successive differences (MSSD), and a measure of vagal tone (V). Children in the zinc supplementation group had greater HP (i.e. slower heart rate), greater range, higher time-independent (HPV) and time-dependent (MSSD) variability in HP, and higher V (P < 0.05) during baseline. Analyses conducted across the cognitive testing period revealed similar effects of prenatal zinc supplementation on cardiac patterns. Concurrent child zinc plasma concentration was also associated with longer HP, greater variability, and marginally higher range and V (P < 0.10). Differences in cardiac patterns due to prenatal zinc supplementation were detectable in children at 54 mo of age during conditions of both rest and challenge, indicating that supplementing zinc-deficient pregnant women has beneficial long-term consequences for neural development associated with autonomic regulation.
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Affiliation(s)
- Laura E Caulfield
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Wachs TD, Posada G, Carbonell OA, Creed-Kanashiro H, Gurkas P. Infant Nutrition and 12 and 18 Months Secure Base Behavior: An Exploratory Study. INFANCY 2011; 16:91-111. [PMID: 32693480 DOI: 10.1111/j.1532-7078.2010.00040.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A notable omission in studies of developmental links to early nutritional deficiencies is infant attachment. In those few studies investigating associations between infant nutrition and attachment, nutrition was defined solely by physical growth, and infants had moderate-severe growth retardation. In this study, we utilized multiple markers of infant nutrition. Our sample consisted of 172 12-month-old Peruvian infants and their mothers from low-income families, with a follow-up assessment on 77 infants at 18 months. Infants were not severely malnourished, but did have micronutrient deficiencies. Anthropometry, dietary intake, and iron status were used as measures of infant nutrition. Based on infant behavior in a structured laboratory situation, Q-sort techniques were used to rate three attachment markers: infant secure base behavior, interaction quality, and negative emotionality with mother. At 12 months, infant weight was positively related to interaction quality. At 18 months, infant iron status was positively related to secure base behavior. This pattern of findings remained even after statistically controlling for family socioeconomic status and maternal education. Our findings indicate that infant nutritional status is associated with markers of infant attachment and these associations are not restricted just to severely malnourished infants.
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Affiliation(s)
| | - German Posada
- Department of Child Development and Family Studies Purdue University
| | | | | | - Pinar Gurkas
- Department of Psychology & Sociology Columbus State University
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Santos JN, Lemos SMA, Vieira T, Lamounier JA. Fatores favoráveis à recuperação do quadro clínico de crianças anêmicas: um estudo exploratório. REVISTA CEFAC 2010. [DOI: 10.1590/s1516-18462010005000121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
OBJETIVO: investigar a existência de aspectos do ambiente familiar de crianças anêmicas que possam ser considerados favoráveis à recuperação do quadro de anemia e ao desenvolvimento da linguagem. MÉTODOS: trata-se de um estudo de caso de crianças com anemia. As crianças (n = 11) foram submetidas anteriormente ao tratamento clínico e avaliação da linguagem. Após 12 meses, foram reavaliadas nos aspectos clínicos e da linguagem, acrescentando-se a investigação dos recursos do ambiente familiar. Deste grupo, foram selecionados três casos que refletem diferentes evoluções do quadro clínico da anemia e do desenvolvimento da linguagem, a fim de explorar as contribuições do ambiente familiar na melhora desses aspectos. RESULTADOS: a comparação das variáveis entre as crianças que obtiveram melhora ou não no tratamento medicamentoso mostra diferença estatisticamente nos valores de hemoglobina e tempo de aleitamento materno (p<0,05). A análise dos três casos revela que a situação ambiental pode ser agravante do quadro clínico da criança. CONCLUSÕES: a qualidade dos recursos domiciliares, o tempo de aleitamento materno e as práticas parentais em relação à criança podem ter contribuído para a adequada recuperação da criança nos aspectos focalizados.
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Affiliation(s)
- Juliana Nunes Santos
- Universidade Federal de Minas Gerais; Universidade Federal de Minas Gerais, Brasil
| | | | - Therezinha Vieira
- Universidade de São Paulo; Universidade Federal de Minas Gerais, Brasil
| | - Joel Alves Lamounier
- Universidade Federal de Minas Gerais, Brasil; Universidade da Califórnia em Los Angeles, EUA
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Kon N, Tanaka K, Sekigawa M, Negishi Y, Yoshikawa N, Hisata K, Shoji H, Shimizu T. Association between iron status and neurodevelopmental outcomes among VLBW infants. Brain Dev 2010; 32:849-54. [PMID: 20456882 DOI: 10.1016/j.braindev.2009.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 11/24/2009] [Accepted: 12/14/2009] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Our purpose was to evaluate iron status and neurodevelopmental outcomes in infants with and without extrauterine growth restriction (EUGR). METHODS This observational study evaluated 38 medically stable premature infants, with birth weights below 1500g. Iron status was determined by measuring venous levels of Hb, Fe, and serum ferritin. The infants were divided into EUGR and non-EUGR groups. At a corrected age of 18months, neurodevelopmental outcomes were checked using the Bayley scales, and body weight, body length, and head circumference were measured. RESULTS Hb levels at corrected ages of 1 and 3months and iron at a corrected age of 1 and 9months were significantly lower in the EUGR group compared with those of the non-EUGR group. There was no significant difference in the MDI score between the groups, but the PDI score at a corrected age of 18months was significantly lower in the EUGR group. We found a positive correlation between the serum level of Fe at 1month of age and PDI score at 18months of age. Head circumference at a corrected age of 18months did not differ between two groups, although body weight and length were lower in the EUGR group. CONCLUSIONS Developmental outcome in preterm infants at a corrected age of 18months may be influenced by nutritional factors, including iron status, during their early life.
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Affiliation(s)
- Noriko Kon
- Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan
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Lukowski AF, Koss M, Burden MJ, Jonides J, Nelson CA, Kaciroti N, Jimenez E, Lozoff B. Iron deficiency in infancy and neurocognitive functioning at 19 years: evidence of long-term deficits in executive function and recognition memory. Nutr Neurosci 2010; 13:54-70. [PMID: 20406573 DOI: 10.1179/147683010x12611460763689] [Citation(s) in RCA: 186] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Iron deficiency in infancy negatively impacts a variety of neurodevelopmental processes at the time of nutrient insufficiency, with persistent central nervous system alterations and deficits in behavioral functioning, despite iron therapy. In rodent models, early iron deficiency impairs the hippocampus and the dopamine system. We examined the possibility that young adults who had experienced chronic, severe, iron deficiency as infants would exhibit deficits on neurocognitive tests with documented frontostriatal (Trail Making Test, Intra-/Extra-dimensional Shift, Stockings of Cambridge, Spatial Working Memory, Rapid Visual Information Processing) and hippocampal specificity (Pattern Recognition Memory, Spatial Recognition Memory). Participants with chronic, severe iron deficiency in infancy performed less well on frontostriatal-mediated executive functions, including inhibitory control, set-shifting, and planning. Participants also exhibited impairment on a hippocampus-based recognition memory task. We suggest that these deficits may result from the long-term effects of early iron deficiency on the dopamine system, the hippocampus, and their interaction.
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Affiliation(s)
- Angela F Lukowski
- Department of Psychology and Social Behavior, University of California, Irvine, California 92697, USA.
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Abstract
OBJECTIVE This study was conducted to compare quality of mother-infant interaction during feeding in infants with or without iron-deficiency anemia (IDA). METHOD Infants and caregivers were screened at their 9- to 10-month-old health maintenance visits at an inner-city clinic in Detroit. Those who were full-term and healthy received a venipuncture blood sample to assess iron status. Of the 77 infants who met final iron status criteria, 68 infants and mothers were videotaped during feeding interaction at the Child Development Research Laboratory. The quality of mother-infant interaction during feeding was scored on the Nursing Child Assessment Feeding Scale. Twenty-five infants with IDA (hemoglobin [HB] <110 g/L and at least 2 abnormal iron measures) were compared to 43 nonanemic infants (HB > or = 110 g/L) using analysis of variance and general linear models with covariate control. RESULTS Mothers of IDA infants responded with significantly less sensitivity to infant cues and less cognitive and social-emotional growth fostering behavior than mothers of nonanemic infants. The pattern of results was similar for scales of contingent behaviors. The magnitude of the differences in maternal ratings was large (0.8-1.0 SD after covariate adjustment). IDA infants were rated significantly lower on clarity of cues and overall (effect sizes 0.5 SD). CONCLUSION IDA in infancy was associated with less optimal mother-infant interaction during feeding. Future interventions might target feeding interaction and consider effects on infant iron status and developmental/behavioral outcomes among IDA infants, as well as infant feeding practices per se.
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Abstract
Recent studies of the effects of developmental iron deficiency (ID) and iron deficiency anemia in nonhuman primates have provided new insights into this widespread and well-recognized human nutritional deficiency. The rhesus monkey was the animal model in these experiments, which used extensive hematological and behavioral evaluations in addition to noninvasive brain measures. Two important findings were as follows: 1) different behavioral consequences depending on the timing of ID relative to brain developmental stages and 2) the potential for long-lasting changes in brain iron regulatory systems. Further work in this model, including integration with studies in humans and in laboratory rodents, is ongoing.
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Affiliation(s)
- Mari S Golub
- Brain Mind and Behavior Unit, California National Primate Research Center, University of California, Davis, CA, USA.
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38
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Corapci F, Calatroni A, Kaciroti N, Jimenez E, Lozoff B. Longitudinal evaluation of externalizing and internalizing behavior problems following iron deficiency in infancy. J Pediatr Psychol 2009; 35:296-305. [PMID: 19736288 DOI: 10.1093/jpepsy/jsp065] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study examined externalizing and internalizing behavior problem trajectories as a function of both iron status in infancy and infant characteristics. METHODS A sample of 185 healthy Costa Rican children who either had chronic, severe iron deficiency or good iron status in infancy were followed for 19 years. RESULTS Mother ratings of externalizing and internalizing problems from age 5 to 11-14 years were higher for the chronic iron deficiency group compared with those with the good iron status. Iron deficiency in infancy predicted persisting externalizing problems over this time period, especially for those with low physical activity in infancy. Beyond adolescence, youth in the chronic iron deficiency group did not report more problems than those in the good iron group. CONCLUSIONS These findings underscore the importance of considering infant iron status along with early behavioral characteristics to better identify those children at greatest risk for persisting long-term behavior problems.
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Affiliation(s)
- Feyza Corapci
- Center for Human Growth and Development, Department of Pediatrics and Communicable Diseases, University of Michigan, 300 N. Ingalls, Ann Arbor, MI 48109-0406, USA
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Coe CL, Lubach GR, Bianco L, Beard JL. A history of iron deficiency anemia during infancy alters brain monoamine activity later in juvenile monkeys. Dev Psychobiol 2009; 51:301-9. [PMID: 19194962 DOI: 10.1002/dev.20365] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Both during and after a period of iron deficiency (ID), iron-dependent neural processes are affected, which raises the potential concern that the anemia commonly experienced by many growing infants could have a protracted effect on the developing brain. To further investigate the effects of ID on the immature brain, 49 infant rhesus monkeys were evaluated across the first year of life. The mothers, and subsequently the infants after weaning, were maintained on a standardized diet containing 180 mg/kg of iron and were not provided other iron-rich foods as treats or supplements. As the infants grew, they were all screened with hematological tests, which documented that 16 (33.3%) became markedly ID between 4 and 8 months of age. During this anemic period and subsequently at 1 year of age, cerebrospinal fluid (CSF) specimens were collected to compare monoamine activity in the ID and iron-sufficient infants. Monoamine neurotransmitters and metabolite levels were normal at 4 and 8 months of age, but by 1 year the formerly anemic monkeys had significantly lower dopamine and significantly higher norepinephrine levels. These findings indicate that ID can affect the developmental trajectory of these two important neurotransmitter systems, which are associated with emotionality and behavioral performance, and further that the impact in the young monkey was most evident during the period of recovery.
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Affiliation(s)
- Christopher L Coe
- Harlow Center for Biological Psychology, University of Wisconsin, 22 North Charter Street, Madison, WI 53715, USA.
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40
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Abstract
BACKGROUND Iron deficiency is most commonly found in women of reproductive age and infants worldwide, but the influence of maternal iron deficiency on infant development is underexplored. OBJECTIVE The objective was to examine the relation between maternal iron status and mother-child interactions in a randomized, double-blind, intervention trial conducted in South Africa. DESIGN Women were recruited into the study from a health clinic at 6-8 wk postpartum and were classified as either iron-deficient anemic (IDA) or iron-sufficient after blood analysis. IDA mothers received iron supplements of 125 mg FeSO(4) (IDA-Fe; n = 34) or placebo (IDA-PL; n = 30) daily from 10 wk to 9 mo postpartum. The control group (n = 31) consisted of iron-sufficient mothers. Free-play mother-child interaction sessions were videotaped in the clinic at 10 wk (n = 80) and 9 mo (n = 66) postpartum and coded per the Emotional Availability Scales (4 maternal scales: sensitivity, structuring, nonintrusiveness, and nonhostility; 2 infant scales: responsiveness and involvement). RESULTS At 10 wk, scores for maternal sensitivity and child responsiveness were significantly greater in the control group than in the IDA groups (P = 0.028 and 0.009, respectively). At 9 mo, the control and IDA-Fe groups no longer differed. These 2 groups scored significantly better on the maternal sensitivity, structuring, and nonhostility scales and on the child responsiveness scale than did the IDA-PL group (P = 0.007-0.032), whose iron status remained low. CONCLUSION These data indicate that maternal iron deficiency negatively affects mother-child interactions and that iron supplementation protects against these negative effects.
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Affiliation(s)
- Laura E Murray-Kolb
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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41
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Santos JN, Rates SPM, Lemos SMA, Lamounier JA. Anemia em crianças de uma creche pública e as repercussões sobre o desenvolvimento de linguagem. REVISTA PAULISTA DE PEDIATRIA 2009. [DOI: 10.1590/s0103-05822009000100011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Comparar o desenvolvimento de linguagem de crianças anêmicas e não-anêmicas de uma creche pública de Belo Horizonte. MÉTODOS: Estudo transversal com avaliação do desenvolvimento de linguagem de crianças anêmicas (casos) e não-anêmicas (controles) entre dois e seis anos de idade. Todas as crianças realizaram punção digital para detecção da anemia (hemoglobina <11,3g/dL). O Grupo Caso foi constituído por 22 crianças anêmicas e o Controle, por 44 crianças, selecionadas por amostragem aleatória pareada. O desenvolvimento de linguagem de cada um dos participantes foi observado e classificado em duas grandes áreas: aspectos comunicativos (recepção e emissão) e aspectos cognitivos da linguagem, com utilização do Roteiro de Observação de Comportamentos de crianças de zero a seis anos. Índices de desempenho foram aplicado para qualificar as respostas das crianças. RESULTADOS: Os valores médios de hemoglobina dos Grupos Caso e Controle foram 10,6 e 12,5g/dL, respectivamente. Os grupos não diferiram quanto às seguintes variáveis: idade, gênero, aleitamento materno e escolaridade materna. Na avaliação de linguagem, observou-se uma diferença estatisticamente significante nos índices de recepção (p=0,02), emissão (p<0,001) e aspectos cognitivos da linguagem (p<0,001), com pior desempenho das crianças anêmicas. CONCLUSÕES: Crianças anêmicas apresentaram pior desenvolvimento da linguagem em comparação às não-anêmicas. A anemia deve ser considerada um problema relevante de Saúde Pública também pelas possíveis alterações que pode provocar no desenvolvimento da linguagem e, consequentemente, na aprendizagem e futuro desempenho social e profissional da criança.
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Mullineaux PY, Deater-Deckard K, Petrill SA, Thompson LA. Parenting and Child Behaviour Problems: a Longitudinal Analysis of Non-Shared Environment. INFANT AND CHILD DEVELOPMENT 2009; 18:133-148. [PMID: 19436771 DOI: 10.1002/icd.593] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined potential non-shared environmental processes in middle childhood by estimating statistical associations between monozygotic (MZ) twin differences in externalizing and internalizing problems and positive social engagement, and differential maternal positivity and negativity, over 1 year. Seventy-seven pairs of identical twins participated (M = 6.08-years old, 65% male) in two annual home visits. Observers' ratings and maternal reports were gathered. At both assessments, the twin who showed more conduct problems (maternal report and observers' ratings) and less positive social engagement (positive affect, responsiveness) received more maternal negativity and less maternal warmth (self-reports and observers' ratings), relative to his or her genetically identical co-twin. The same patterns held over time, for the associations between change in differential MZ twin conduct problems and social engagement and change in differential maternal behaviour. Effects for child internalizing problems were not consistent within or across raters. Overall, these results indicated that differential maternal warmth and negativity-self-perceived and observed by others- are important aspects of sibling differentiation for both problematic and adaptive behaviours during middle childhood.
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Affiliation(s)
- Paula Y Mullineaux
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Ayala R, Otero GA, Porcayo Mercado R, Pliego-Rivero FB. Delayed CNS maturation in iron-deficient anaemic infants. Nutr Neurosci 2009; 11:61-8. [PMID: 18510805 DOI: 10.1179/147683008x301342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Direct evidence of CNS developmental alterations in iron-deficient anaemic (IDA) infants was obtained. Twenty 3-15-month-old IDA and 20 non-IDA infants (age and gender matched), healthy in every other respect, were studied. Complete blood and iron kinetics tests determined an IDA status. Psychomotor development was assessed through the test of Rogers and co-workers [Rogers SJ, Donovan CM, D'Eugenio D, Brown SL, Whiteside E, Moersch MS, Schafer DS. (eds) Developmental Programming for Infants and Young Children, Vol 2. University of Michigan Press, 1981] and under the 10-20 International System qEEG was performed (sleep/stage II). A Pearson's correlation test was applied between haematological, psychomotor and broad band EEG variables, and through ANOVA psychomotor and AP means were compared. IDA infants showed lower scores in cognition, fine motor and social/emotional areas, higher delta/theta and lower alpha power. Most correlations between haematological/psychological variables were positive. Delta/theta correlations were negative with self-care/gross and motor items while alpha/beta AP showed positive correlations with psychomotor and haematological variables. A clear association was found between EEG alterations and a low haematological/iron profile leading to a delayed psychomotor development.
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Affiliation(s)
- Rosalva Ayala
- Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, México
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Ensor R, Hughes C. With a little help from my friends: maternal social support, via parenting, promotes willingness to share in preschoolers born to young mothers. INFANT AND CHILD DEVELOPMENT 2009. [DOI: 10.1002/icd.643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
Infants who experience iron deficiency during the first 6-12 mo of life are likely to experience persistent effects of the deficiency that alter functioning in adulthood. A lack of sufficient iron intake may significantly delay the development of the central nervous system as a result of alterations in morphology, neurochemistry, and bioenergetics. Depending on the stage of development at the time of iron deficiency, there may be an opportunity to reverse adverse effects, but the success of repletion efforts appear to be time dependent. Publications in the past several years describe the emerging picture of the consequences of iron deficiency in both human and animal studies. The mechanisms for iron accumulation in the brain and perhaps redistribution are being understood. The data in human infants are consistent with altered myelination of white matter, changes in monoamine metabolism in striatum, and functioning of the hippocampus. Rodent studies also show effects of iron deficiency during gestation and lactation that persist into adulthood despite restoration of iron status at weaning. These studies indicate that gestation and early lactation are likely critical periods when iron deficiency will result in long-lasting damage.
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Lozoff B, Beard J, Connor J, Felt B, Georgieff M, Schallert T. Long-Lasting Neural and Behavioral Effects of Iron Deficiency in Infancy. Nutr Rev 2008. [DOI: 10.1111/j.1753-4887.2006.tb00243.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Selective impairment of cognitive performance in the young monkey following recovery from iron deficiency. J Dev Behav Pediatr 2008; 29:11-7. [PMID: 18300719 DOI: 10.1097/dbp.0b013e31815f24a9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE While poor nutrition during development is an obvious concern, the magnitude and duration of the neural and cognitive deficits that occur after moderate iron deficiency in infancy have remained controversial. A nonhuman primate model of infancy anemia was refined to investigate the effects on cognitive performance. METHODS Young rhesus monkeys that experienced a delimited period of iron deficiency were tested on a series of cognitive tasks following normalization of their hematological status. Beginning at 8 to 9 months of age, 2 months after weaning from their mothers and consumption of solid food, the previously iron-deficient (ID) monkeys (n = 17) were compared to age- and gender-matched, iron-sufficient (IS) (n = 27) monkeys on a series of three tests of cognitive performance. Using the Wisconsin General Testing Apparatus, a Black/White Discrimination task was followed by acquisition of Black/White Reversal (BWR). RESULTS ID monkeys were significantly slower at mastering the BWR task (p < .04), which required reversing and inhibiting the previously learned response. In addition, ID infants were significantly less object oriented (p < .017) and more distractible (p < .018). However, on two subsequent tests, the Concurrent Object Discrimination and Delayed Non-Match-to-Sample, there were no differences in acquisition, performance, or behavioral reactivity. CONCLUSIONS The initial cognitive and behavioral deficits are similar to those seen in follow-up evaluations of anemic children, but the limited extent of the impairment after this moderate iron deficiency that involved a select nutrient deficiency is encouraging for the benefits attainable through early identification and iron supplementation.
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Steinmacher J, Pohlandt F, Bode H, Sander S, Kron M, Franz AR. Randomized trial of early versus late enteral iron supplementation in infants with a birth weight of less than 1301 grams: neurocognitive development at 5.3 years' corrected age. Pediatrics 2007; 120:538-46. [PMID: 17766527 DOI: 10.1542/peds.2007-0495] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Iron deficiency in early childhood may impair neurodevelopment. In a masked, randomized, controlled trial of early versus late enteral iron supplementation in preterm infants with birth weights of <1301 g, early iron supplementation reduced the incidence of iron deficiency and the number of blood transfusions. OBJECTIVE We sought to examine whether early enteral iron supplementation improves neurocognitive and motor development in these infants. METHODS Children who participated in the above mentioned trial were evaluated by applying the Kaufmann Assessment Battery for Children and the Gross Motor Function Classification Scale at the age of school entry. RESULTS Of the 204 infants initially randomized, 10 died and 30 were lost to follow-up. A total of 164 (85% of the survivors) were evaluated at a median corrected age of 5.3 years. In this population (n = 164), the mean (+/-SD) mental processing composite in the early iron group was 92 (+/-17) versus 89 (+/-16) in the late iron group. An abnormal neurologic examination was found in 17 of 90 versus 26 of 74, and a Gross Motor Function Classification Scale score of >1 was found in 2 of 90 versus 5 of 74, respectively. Fifty-nine of 90 children in the early iron group were without disability, compared with 40 of 74 in the late iron group. Severe disability was found in 5 of 90 versus 6 of 74 children and 67 of 90 versus 49 of 74 qualified for regular schooling, respectively. CONCLUSIONS Early enteral iron supplementation showed a trend toward a beneficial effect on long-term neurocognitive and psychomotor development and showed no evidence for any adverse effect. Because the initial study was not designed to evaluate effects on neurocognitive development, the power was insufficient to detect small but potentially clinically relevant improvements. Additional studies are required to confirm the trend towards a better outcome observed in the early iron group.
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Affiliation(s)
- Jochen Steinmacher
- Division of Neonatology, Department of Pediatrics, University of Ulm, Ulm, Germany
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Lozoff B, Corapci F, Burden MJ, Kaciroti N, Angulo-Barroso R, Sazawal S, Black M. Preschool-aged children with iron deficiency anemia show altered affect and behavior. J Nutr 2007; 137:683-9. [PMID: 17311960 PMCID: PMC3311027 DOI: 10.1093/jn/137.3.683] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study compared social looking and response to novelty in preschool-aged children (47-68 mo) with or without iron deficiency anemia (IDA). Iron status of the participants from a low-income community in New Delhi, India, was based on venous hemoglobin, mean corpuscular volume, and red cell distribution width. Children's social looking toward adults, affect, and wary or hesitant behavior in response to novelty were assessed in a semistructured paradigm during an in-home play observation. Affect and behavior were compared as a function of iron status: IDA (n = 74) vs. nonanemic (n = 164). Compared with nonanemic preschoolers, preschoolers with IDA displayed less social looking toward their mothers, moved close to their mothers more quickly, and were slower to display positive affect and touch novel toys for the first time. These results indicate that IDA in the preschool period has affective and behavioral effects similar to those reported for IDA in infancy.
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Affiliation(s)
- Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI 48109-0406, USA.
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Lozoff B, Beard J, Connor J, Barbara F, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev 2006; 64:S34-43; discussion S72-91. [PMID: 16770951 PMCID: PMC1540447 DOI: 10.1301/nr.2006.may.s34-s43] [Citation(s) in RCA: 589] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Infants are at high risk for iron deficiency and iron-deficiency anemia. This review summarizes evidence of long-term effects of iron deficiency in infancy. Follow-up studies from preschool age to adolescence report poorer cognitive, motor, and social-emotional function, as well as persisting neurophysiologic differences. Research in animal models points to mechanisms for such long-lasting effects. Potential mechanisms relate to effects of iron deficiency during brain development on neurometabolism, myelination, and neurotransmitter function.
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Affiliation(s)
- Betsy Lozoff
- Center for Human Growth and Development and the Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor 48109, USA.
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