Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy

Objective. To determine the long-term effects of iron deficiency in infancy . Design. Longitudinal follow-up study of children who had been tested and tr eated for iron deficiency as infants. Setting. Periurban community near San Jose, Costa Rica. Participants. Of the original 191 participants, 87% were reevaluated at 11 to 14 years old (average age: 12.3 years). The children were free of iron d eficiency and growing normally by US standards. Those who had chronic, seve re iron deficiency in infancy (n = 48) were compared with those who had goo d iron status before and/or after iron therapy in infancy (n = 114). Outcome Measures. Comprehensive set of cognitive, socioemotional, and motor tests and measures of school functioning. Results. Children who had severe, chronic iron deficiency in infancy scored lower on measures of mental and motor functioning. After control for backg round factors, differences remained statistically significant in arithmetic achievement and written expression, motor functioning, and some specific c ognitive processes (spatial memory, selective recall, and tachistoscopic th reshold). More of the formerly iron-deficient children had repeated a grade and/or been referred for special services or tutoring. Their parents and t eachers rated their behavior as more problematic in several areas, agreeing in increased concerns about anxiety/depression, social problems, and atten tion problems. Conclusions. Severe, chronic iron deficiency in infancy identifies children who continue at developmental and behavioral risk >10 years after iron tre atment.