Low-Dose Iron Supplementation in Infancy Modestly Increases Infant Iron Status at 9 Mo without Decreasing Growth or Increasing Illness in a Randomized Clinical Trial in Rural China

Autor(es):Mostrar menos -

Lozoff, Betsy ^{[1, 2]} ; Jiang, Yaping ^[3] ; Li, Xing ^[4] ; Zhou, Min ^[5] ; Richards, Blair ^[1] ; Xu, Guobin ^[3] ; Clark, Katy M. ^[1] ; Liang, Furong ^[4] ; Kaciroti, Niko ^[1] ; Zhao, Gengli ^[5] ; Santos, Denise C. C. ^[6] ; Zhang, Zhixiang ^[4] ; Tardif, Twila ^[1] ; Li, Ming ^[4]

Afiliação do(s) autor(es)

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

^[2] Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 - USA

^[3] Peking Univ, Hosp 1, Clin Lab, Beijing 100871 - Peoples R China

^[4] Peking Univ, Hosp 1, Dept Pediat, Beijing 100871 - Peoples R China

^[5] Peking Univ, Hosp 1, Womens & Childrens Hlth Ctr, Beijing 100871 - Peoples R China

^[6] Univ Metodista Piracicaba, Human Movement Sci Grad Program, Piracicaba - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Journal of Nutrition; v. 146, n. 3, p. 612-621, MAR 1 2016.
• Citações Web of Science: 7

Resumo

Background: Previous trials of iron supplementation in infancy did not consider maternal iron supplementation. Objective: This study assessed effects of iron supplementation in infancy and/or pregnancy on infant iron status, illnesses, and growth at 9 mo. Methods: Enrollment occurred from December 2009 to June 2012 in Hebei, China. Infants born to women in a pregnancy iron supplementation trial were randomly assigned 1: 1 to iron {[}similar to 1 mg Fe/(kg.d) as oral iron proteinsuccynilate] or placebo from 6 wk to 9 mo, excluding infants with cord ferritin <35 mu g/L. Study groups were pregnancy placebo/infancy placebo (placebo/placebo), pregnancy placebo/infancy iron (placebo/iron), pregnancy iron/infancy placebo (iron/placebo), and pregnancy iron/infancy iron (iron/iron). The primary outcome was 9-mo iron status: iron deficiency (ID) by cutoff (>= 2 abnormal iron measures) or body iron <0 mg/kg and ID + anemia (hemoglobin < 110 g/L). Secondary outcomes were doctor visits or hospitalizations and weight or length gain from birth to 9 mo. Statistical analysis by intention to treat and dose-response (between number of iron bottles received and outcome) used logistic regression with concomitant RRs and general linear models, with covariate control as applicable. Results: Of 1482 infants randomly allocated, 1276 had 9-mo data (n = 312-327/group). Iron supplementation in infancy, but not pregnancy, reduced ID risk: RRs (95% CIs) were 0.89 (0.79, 0.998) for placebo/iron compared to placebo/placebo, 0.79 (0.63, 0.98) for placebo/iron compared to iron/placebo, 0.87 (0.77, 0.98) for iron/iron compared to placebo/placebo, and 0.86 (0.77, 0.97) for iron/iron compared to iron/placebo. However, >60% of infants still had ID at 9 mo. Receiving more bottles of iron in infancy was associated with better infant iron status at 9 mo but only among iron-supplemented infants whose mothers were also iron supplemented (i.e., the iron/iron group). There were no group differences in hospitalizations or illnesses and no adverse effects on growth overall or among infants who were iron sufficient at birth. Conclusions: Iron supplementation in Chinese infants reduced ID at 9 mo without adverse effects on growth or illness. Effects of iron supplementation in pregnancy were observed only when higher amounts of iron were distributed in infancy. This trial was registered at clinicaltrials.gov as NCT00613717. (AU)

• Processo FAPESP: 14/00018-0 - Efeitos da prevenção da deficiência de ferro nos períodos pré e pós-natal no desenvolvimento motor de lactentes
• Beneficiário: Denise Castilho Cabrera Santos
• Modalidade de apoio: Bolsas no Exterior - Pesquisa