IRON-DEFICIENCY ANEMIA AND INFANT DEVELOPMENT - EFFECTS OF EXTENDED ORAL IRON THERAPY

Objective: To determine whether extended oral iron therapy corrects lo wer developmental test scores in infants with iron-deficiency anemia. Study design: Double-blind, controlled trial in Costa Rica involving 3 2 12- to 23-month-old infants with iron-deficiency anemia and 54 nonan emic control subjects. Anemic infants were treated with orally adminis tered 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 m onths. Results: Iron-deficient anemic infants received lower mental te st scores than nonanemic infants at all three time points (p <0.05 pre treatment and at 3 months, p=0.07 at 6 months). There were no signific ant differences in motor test scores. More of the anemic infants were rated as unusually fearful and unhappy. Anemic infants came from famil ies with lower maternal education and less support for child developme nt and were less likely to be breast fed, were weaned earlier, and con sumed more cow milk. Conclusions: Lower mental test scores persisted i n infants with iron-deficiency anemia despite extended oral iron thera py and an excellent hematologic response. Iron-deficiency anemia may s erve as a marker for a variety of nutritional and family disadvantages that may adversely affect infant development.