Iron Suplementation Starting at 12 Months of Age and Developmental Outcomes: Who Benefits.
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Date
2015
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Abstract
Objectives: Iron deficiency has been linked with reduced developmental outcomes in children,
however results are varied. This study aims to investigate the benefit of iron supplementation on
developmental outcomes in under-two year old children.
Methods: A randomized, double-blinded controlled trial was conducted in Lombok, West Nusa
Tenggara Province, Indonesia (ClinicalTrials.gov Identifier: NCT01504633). Two groups
(n=44/group) of 12-17 mo children were compared: Placebo and Fe-group (16mg elemental
iron/day). Indicators of sub-clinical inflammation (CRP, AGP), iron status (serum ferritin/SF,
transferin receptor/sTfR, body iron store/BIS), hemoglobin and development (using BSID II as
mental/MDI, psychomotor/PDI and behavior/BRS scores) were assessed at baseline and after 24-
week supplementation (endline).
Results: Both groups were comparable at baseline (92% anemia, 66% iron deficiency/ID, 62%
IDA). Hemoglobin and iron status indicators were significantly higher at endline in Fe-group, also
there were significant decrease in prevalence of anemia, ID and IDA (p<0.001). However there is
no difference in MDI, PDI and BRS scores between placebo and Fe-group at the endline nor
change of these scores. When stratified by ID and anemia at baseline, iron supplementation can
only prevent significant decrease in MDI in the initially non-anemic subjects.
Conclusions: Within the regime of iron dosage used in this study (equivalent to 2mg/kg.day) iron
supplementation improved hemoglobin and iron status indicators but did not benefit developmental
outcomes. Iron intervention delivered for children <12mo may be too late due to prolonged deficiency. Further studies when iron intervention is started at earlier age or even prenatally are
needed.
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Fahmida Umi, Htet Min Kyaw, Kolopaking Risatianti. Iron Suplementation Starting at 12 Months of Age and Developmental Outcomes: Who Benefits. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 967-968.