Effect of Iron-Deficiency Anemia on Cognitive Skills and Neuromaturation in Infancy and Childhood

Abstract

Iron-deficiency anemia in infancy has been consistently shown to negatively influence performance in tests of psychomotor development. In most studies of short-term follow-up, lower scores did not improve with iron therapy, despite complete hematologic replenishment. The negative impact on psychomotor development of iron-deficiency anemia (IDA) in infancy has been well documented in more than a dozen studies during the last two decades. Two studies will be presented here to further support this assertion. Additionally, we will present some data referring to longer follow-up at 5 and 10 years as well as data concerning recent descriptions of the neurologic derangements that may underlie these behavioral effects. To evaluate whether these deficits may revert after long-term observation, a cohort of infants was re-evaluated at 5 and 10 years of age. Two studies have examined children aged 5 years who had anemia as infants using comparable tools of cognitive development showing persisting and consistent important disadvantages in those who were formerly anemic. These tests were better predictors of future achievement than psychomotor scores. These children were again examined at 10 years and showed lower school achievement and poorer fine-hand movements. Studies of neurologic maturation in a new cohort of infants aged 6 months included auditory brain stem responses and naptime 18-lead sleep studies. The central conduction time of the auditory brain stem responses was slower at 6, 12, and 18 months and at 4 years, despite iron therapy beginning at 6 months. During the sleep-wakefulness cycle, heart-rate variability--a developmental expression of the autonomic nervous system--was less mature in anemic infants. The proposed mechanisms are altered auditory-nerve and vagal-nerve myelination, respectively, as iron is required for normal myelin synthesis.

Iron deficiency anaemia: Effect on congnitive development in children: A review

“…fetus) may also cause irreversible disturbances and damages to GABA neurotransmitter system. Most of the co-relational and experimental studies done earlier confirmed the hypothesis that iron deficiency of mild to moderate nature has an adverse effect on congnitive development (3,7). Therefore, it may be logical to suggest that impairment of higher mental function like cognition and learning in humans (5, 13) may be linked to changes in neurotransmitter receptors and consequent signal transduction process in the nervous system (28,29).…”

“…Medical evidence show that very severe anaemia is a direct cause of maternal and child mortality (2). Iron deficiency causes varying degrees of impairment in congnitive performance (3), lowered work capacity, lower immunity to infections (4), pregnancy complication e.g. low birth weight babies, poor learning capacity and reduced phychomotor skills (5).…”

Nutritional status of indigenous children at boarding schools in northern Mexico

“…Iron deficiency anaemia (IDA) has been consistently associated with irreversible adverse effects on growth and cognitive performance (Lozoff, 1988;Walter, 1996).…”

Symposium on ‘Nutrition and health in children and adolescents’ Session 2: Dietary quality and dietary recommendations in children and adolescents Dietary quality and adequacy of micronutrient intakes in children

“…Fe-fortified breakfast cereals were positively associated with SF, an effect that has not been shown in comparably young children elsewhere, although Fe-fortified infant cereals have been shown to improve Fe status (Walter, 1993). The negative effect of bread consumption on Fe status seen in the infant study has been reported elsewhere (Michaelsen et al 1995).…”