Anemia within the first 1,000 days of life is primarily attributed to iron deficiency (ID). This period is critical as infants and young children have the highest iron demands. Failure to meet these increased needs exposes children to ID, which has been linked to persistent developmental challenges. Numerous studies have reported neurodevelopmental disorders in children with a history of early-life ID, though findings vary. This systematic review aimed to evaluate the long-term impact of early childhood ID on neurodevelopmental outcomes. Systematic review. A literature search was conducted across five electronic databases (PubMed, Cochrane, Scopus, Sage, and Embase) using the keywords "iron deficiency anemia" and "infant." The JBI critical appraisal tool for cohort studies was used to evaluate study quality. Seventeen relevant cohort studies were identified through the systematic search. Of these, 14 were rated as high quality, while 3 were classified as moderate quality. The neurodevelopmental domains assessed included cognitive deficits (seven studies), motor deficits (four studies), verbal deficits (seven studies), behavioral deficits (nine studies), auditory function (one study), and neuroendocrine function (two studies). Early-life ID disrupts neurodevelopment, leading to persistent cognitive, motor, behavioral, and neuroendocrine impairments. Children with a history of early childhood ID demonstrate poorer cognitive, motor, and behavioral outcomes compared with their non-ID counterparts. Preventing ID within the first 1,000 days of life is essential to mitigate irreversible deficits in motor, cognitive, and behavioral functions.
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