Abstract
One-third of children falter in cognitive development by pre-school age. Iron plays an important role in many neurodevelopmental processes, and animal studies suggest that iron sufficiency in pregnancy and infancy is particularly important for neurodevelopment. However, it is not clear whether iron deficiency directly impacts developmental outcomes, and, if so, whether impact differs by timing of exposure or developmental domain. We searched four databases for studies on iron deficiency or iron supplementation in pregnancy, or at 0–6 months, 6–24 months, or 2–4 years of age. All studies included neurodevelopmental assessments in infants or children up to 4 years old. We then qualitatively synthesized the literature. There was no clear relationship between iron status and developmental outcomes across any of the time windows or domains included. We identified a large quantity of low-quality studies, significant heterogeneity in study design and a lack of research focused on pregnancy and early infancy. In summary, despite good mechanistic evidence for the role of iron in brain development, evidence for the impact of iron deficiency or iron supplementation on early development is inconsistent. Further high-quality research is needed, particularly within pregnancy and early infancy, which has previously been neglected.
Highlights
One-third of children do not reach their developmental potential by pre-school age [1]
Studies comparing iron deficiency (ID) participants to iron deficiency anaemia (IDA) participants without an iron-sufficient (IS) control group were excluded, as they assess the impact of anaemia on brain development as opposed to ID, which is the focus of this study
Evidence is currently sparse, we have identified encouraging findings supporting the possible benefit of iron supplementation in early infancy on developmental outcomes
Summary
One-third of children do not reach their developmental potential by pre-school age [1]. 1000 days of life, from conception to two years of age, are widely recognised as the most important period for brain development. Deficits accrued within this period can have long-term consequences, including poorer academic achievement, mental health and economic productivity across the lifespan [2]. These factors contribute to the continuation of the poverty cycle and stall progress. It is, crucial to understand why some children falter in their development and design preventative and corrective interventions . It is widely agreed that three broad factors are most influential: (i) infection and inflammatory stress, (ii) quality of care and (iii) nutrition [3]
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