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Arch Pediatr Adolesc Med. 2006 Nov;160(11):1108-13.

Double burden of iron deficiency in infancy and low socioeconomic status: a longitudinal analysis of cognitive test scores to age 19 years.

Author information

  • 1Center for Human Growth and Development, and Department of Pediatrics and Communicable Diseases, University of Michigan, 300 N. Ingalls, Ann Arbor, MI 48109, USA. blozoff@umich.edu

Abstract

OBJECTIVE:

To assess change in cognitive functioning after iron deficiency in infancy, depending on socioeconomic status (SES; middle vs low).

DESIGN:

Longitudinal study.

SETTING:

Urban community in Costa Rica (infancy phase [July 26, 1983, through February 28, 1985] through 19-year follow-up [March 19, 2000, through November 4, 2002]).

PARTICIPANTS:

A total of 185 individuals enrolled at 12 to 23 months of age (no preterm or low-birth-weight infants or infants with acute or chronic health problems). The participants were assessed in infancy and at 5, 11 to 14, 15 to 18, and 19 years of age. A total of 97% were evaluated at 5 or 11 to 14 years and 78% at 15 to 18 or 19 years. Individuals who had chronic iron deficiency in infancy (iron deficiency with hemoglobin concentrations < or =10.0 g/dL or, with higher hemoglobin concentrations, not fully corrected within 3 months of iron therapy) were compared with those who had good iron status as infants (hemoglobin concentrations > or =12.0 g/dL and normal iron measures before and/or after therapy).

MAIN OUTCOME MEASURES:

Cognitive change over time (composite of standardized scores at each age).

RESULTS:

For middle-SES participants, scores averaged 101.2 in the group with chronic iron deficiency vs 109.3 in the group with good iron status in infancy and remained 8 to 9 points lower through 19 years (95% confidence interval [CI], -10.1 to -6.2). For low-SES participants, the gap widened from 10 points (93.1 vs 102.8; 95% CI for difference, -12.8 to -6.6) to 25 points (70.4 vs 95.3; 95% CI for difference, 20.6 to 29.4).

CONCLUSIONS:

The group with chronic iron deficiency in infancy did not catch up to the group with good iron status in cognitive scores over time. There was a widening gap for those in low-SES families. The results suggest the value of preventing iron deficiency in infancy.

Comment in

PMID:
17088512
[PubMed - indexed for MEDLINE]
PMCID:
PMC1866361
Free PMC Article

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