Iron-deficiency anemia and infant development: Effects of extended oral iron therapy

Objective: To determine whether extended oral iron therapy corrects lower developmental test scores in infants with iron-deficiency anemia. Study design: Double-blind, controlled trial in Costa Rica involving 32 12- to 23-month-old infants with iron-deficiency anemia and 54 nonanemic control subjects. Anemic infants were treated with orally administered iron for 6 months; half the nonanemic children were treated with iron and half with placebo. Developmental test scores and hematologic status were evaluated before treatment, after 3 months, and after 6 months. Results: Iron-deficient anemic infants received lower mental test scores than nonanemic infants at all three time points (p <0.05 pretreatment and at 3 months, p=0.07 at 6 months). There were no significant differences in motor test scores. More of the anemic infants were rated as unusually fearful and unhappy. Anemic infants came from families with lower maternal education and less support for child development and were less likely to be breast fed, were weaned earlier, and consumed more cow milk. Conclusions: Lower mental test scores persisted in infants with iron-deficiency anemia despite extended oral iron therapy and an excellent hematologic response. Iron-deficiency anemia may serve as a marker for a variety of nutritional and family disadvantages that may adversely affect infant development.