Long-term effects of iron and zinc supplementation during infancy on cognitive function at 9 y of age in northeast Thai children: a follow-up study

Abstract

Iron and zinc are important micronutrients for child growth and development. One would expect that iron and zinc supplementation in infancy would affect long-term cognitive development and school achievement, but this has not been evaluated. We investigated the effect of iron or zinc supplementation or both during infancy on cognitive performance 8 y later. A follow-up study was performed in 560 children aged 9 y or 92% of those who had participated in a randomized controlled trial involving 4 groups who received daily iron, zinc, iron plus zinc, or a placebo at 4-6 mo of age for 6 mo. Cognitive performance was assessed by using the Wechsler Intelligence Scale for Children-Third Edition (Thai version), the Raven's Colored Progressive Matrices (CPM), and school performance tests. General linear mixed models were used to assess long-term effects. No significant differences in any of the outcomes at 9 y of age were observed at follow-up between the 4 groups. Mean intelligence quotients ranged across groups from 92.9 to 93.7 for full scale, 93.9-95.4 for verbal, and 93.1-94.0 for performance. The Raven's CPM score ranged from 21.4 to 22.4. Supplementation with iron or zinc or both during infancy does not lead to long-term cognitive improvement in 9-y-old children. This trial was registered at clinicaltrials.gov as NCT00824304.