Iron Supplementation in Pregnancy or Infancy and Motor Development: A Randomized Controlled Trial

Author(s)

Angulo-Barroso, Rosa M. ^{[1, 2]} ; Li, Ming ^[3] ; Santos, Denise C. C. ^{[1, 4]} ; Bian, Yang ^[3] ; Sturza, Julie ^[1] ; Jiang, Yaping ^[5] ; Kaciroti, Niko ^[1] ; Richards, Blair ^[1] ; Lozoff, Betsy ^{[1, 6]}

Affiliation

^[1] Univ Michigan, Ctr Human Growth & Dev, Ann Arbor, MI 48109 - USA

^[2] Calif State Univ Northridge, Dept Kinesiol, Redwood Hall 250, 18111 Nordhoff St, Northridge, CA 91330 - USA

^[3] Peking Univ, Hosp 1, Dept Pediat, Beijing 100871 - Peoples R China

^[4] Univ Metodista Piracicaba, Human Movement Sci Grad Program, Piracicaba, SP - Brazil

^[5] Peking Univ, Hosp 1, Clin Lab, Beijing 100871 - Peoples R China

^[6] Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 - USA

• Document type: Journal article
• Source: PEDIATRICS; v. 137, n. 4 APR 2016.
• Web of Science Citations: 41

Abstract

BACKGROUND AND OBJECTIVE: Insufficient iron levels for optimal fetal and infant development is a concern during pregnancy and infancy. The goal of this study was to assess the effects of iron supplementation in pregnancy and/or infancy on motor development at 9 months. METHODS: The study was a randomized controlled trial (RCT) of infancy iron supplementation linked to an RCT of pregnancy iron supplementation, conducted in Hebei, China. A total of 1482 infants were randomly assigned to receive placebo (n = 730) or supplemental iron (n = 752) from 6 weeks to 9 months. Gross motor development (assessed by using the Peabody Developmental Motor Scale, Second Edition, instrument) was the primary outcome. Neurologic integrity and motor quality were secondary outcomes. RESULTS: Motor outcome was available for 1196 infants, divided into 4 supplementation period groups: (1) placebo in pregnancy/placebo in infancy (n = 288); (2) placebo in pregnancy/iron in infancy (n = 305); (3) iron in pregnancy/placebo in infancy (n = 298); and (4) iron in pregnancy/iron in infancy (n = 305). Using the Peabody Developmental Motor Scale, instrument, iron supplementation in infancy but not pregnancy improved gross motor scores: overall, P < .001; reflexes, P = .03; stationary, P < .001; and locomotion, P < .001. Iron supplementation in infancy improved motor scores by 0.3 SD compared with no supplementation or supplementation during pregnancy alone. Effects of iron supplementation in infancy alone were similar to effects with iron in both pregnancy and infancy. CONCLUSIONS: The RCT design supports the causal inference that iron supplementation in infancy, with or without iron supplementation in pregnancy, improved gross motor test scores at 9 months. (AU)

• FAPESP's process: 14/00018-0 - Effects of the prevention of iron deficiency in pre-and postnatal periods on infant’s motor development
• Grantee: Denise Castilho Cabrera Santos
• Support Opportunities: Scholarships abroad - Research