Iron deficiency anemia and cognitive function in infancy

R. Colin Carter, Joseph L. Jacobson, Matthew J. Burden, Rinat Armony-Sivan, Neil C. Dodge, Mary Lu Angelilli, Betsy Lozoff, Sandra W. Jacobson

Research output: Contribution to journalArticlepeer-review

190 Scopus citations

Abstract

OBJECTIVES: This study examined effects of iron deficiency anemia (IDA) on specific domains of infant cognitive function and the role of IDA-related socioemotional deficits in mediating and/or moderating these effects. METHODS: Infants were recruited during routine 9-month visits to an inner-city clinic. IDA was defined as hemoglobin level < 110 g/L with ≥ 2 abnormal iron deficiency indicators (mean corpuscular volume, red cell distribution width, zinc protoporphyrin, transferrin saturation, and ferritin). At 9 and 12 months, the Fagan Test of Infant Intelligence (FTII); A-not-B task; Emotionality, Activity, and Sociability Temperament Survey; and Behavior Rating Scale were administered. Analyses were adjusted for potential confounders, including age and sociodemographic variables. RESULTS: Twenty-eight infants met criteria for IDA, 28 had nonanemic iron deficiency (NA ID) and 21 had iron sufficiency (IS). There was a linear effect for object permanence at 9 months: infants with IDA were least likely to exhibit object permanence, IS most likely, and NA ID intermediate. Infants with IDA and those with hemoglobin level ≤ 105 g/L showed poorer recognition memory on the FTII than infants without IDA. The Behavior Rating Scale orientation/engagement measure partially mediated these effects. Stronger effects of IDA on these outcomes were seen in infants who scored more poorly on the socioemotional measures. CONCLUSIONS: These data indicate poorer object permanence and short-term memory encoding and/or retrieval in infants with IDA at 9 months. These cognitive effects were attributable, in part, to IDA-related deficits in socioemotional function. Children with poor socioemotional performance seem to be more vulnerable to the effects of IDA on cognitive function.

Original languageEnglish
Pages (from-to)e427-e434
JournalPediatrics
Volume126
Issue number2
DOIs
StatePublished - Aug 2010
Externally publishedYes

Funding

FundersFunder number
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentP01HD039386

    Keywords

    • Infancy
    • Infant cognition
    • Iron deficiency anemia
    • Object permanence
    • Recognition memory
    • Socioemotion

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