The effect of iron deficiency and mental stimulation on Indonesian children's cognitive performance and development. Treatment with iron increases weight gain and psychomotor development. Iron deficiency anemia: adverse effects on infant psychomotor development. Low prevalence of iron-deficiency anaemia among Inuit preschool children: Nunavut Inuit Child Health Survey, 2007-2008. Infancy: mental and motor development. Effects of Vitamin A Supplementation on Iron Status Indices and Iron Deficiency Anaemia: A Randomized Controlled Trial The ratio of serum transferrin receptor and serum ferritin in the diagnosis of iron status
Three studies conducted in Indonesia will be described . Soewondo ( 12 ) investigated the relation of iron deficiency and cognitive function and impact of iron supplementation on verbal intelligence , attention and concept learning among iron deficient children without anemia and iron deficient anemic children . Half of 176 children , aged 3 - 6 years , received elemental Fe for 8 weeks and the other half received  placebo . There were significant changes from pre to post intervention evaluations in ferritin , transferrin saturation , free erythrocyte protoporphyrin , and hemoglobin in the iron deficient anemic children . Pre and post treatment psychological test data showed that iron deficiency anemia produced alterations in cognitive processes related to visual attention and concept acquisition . These alterations can be reversed with iron treatment . Idjradinata ( 4 ) assessed the impact of iron supplementation on iron deficient infant 's mental and psychomotor development . Hundred twenty six subjects aged 12 to 18 month were r and omly assigned to either iron treatment or placebo intervention . After 4 months of iron supplementation , the hemoglobin , ferritin and transferrin saturation changed significantly in the iron deficient infants . A developmental delay was observed in the iron deficient anemic infants before intervention and the conditions were reversed after 4 months of iron treatment . Soemiarti ( 8) examined the effectiveness of a  training course  given to mothers of children aged 12 to 24 month on the rearing environment and consequently to the child 's development .  The subjects were 69 mothers of 20 - 35 years old . The training lasted for 21 days by giving mothers training using the program " Ibu Maju Anak Bermutu " . The rearing environment improved , also the child 's mental and psychomotor development Previous work at this hospital and elsewhere has shown that anaemia in toddlers is common and is associated with psychomotor delay . It seemed unclear , however , whether this association was cause and effect or merely due to the same underprivileged environment . A double blind r and omised intervention study was , therefore , performed . After an initial assessment 97 children with anaemia ( haemoglobin 8 - 11 g/dl ) aged 17 - 19 months received either iron and vitamin C or vitamin C only ( control group ) for two months and were then reassessed . The children who received the iron had an increased rate of weight gain and more of them achieved the expected rate of development . While iron deficiency anaemia is unlikely to be the only factor in the slower development of children living in underprivileged circumstances , it can at least be easily identified and treated . Routine child health surveillance in such areas should include a haemoglobin determination In a double-blind , placebo-control prospect i ve cohort study of 196 infants from birth to 15 months of age , assessment was made at 12 months of age of the relationship between iron status and psychomotor development , the effect of a short-term ( 10-day ) trial of oral iron vs placebo , and the effect of long-term ( 3 months ) oral iron therapy . Development was assessed with the mental and psychomotor indices and the infant behavior record of the Bayley Scales of Infant Development in 39 anemic , 30 control , and 127 nonanemic iron-deficient children . Anemic infants had significantly lower Mental and Psychomotor Developmental Index scores than control infants or nonanemic iron-deficient infants ( one-way analysis of variance , P less than .0001 ) . Control infants and nonanemic iron-deficient infants performed comparably . No difference was noted between the effect of oral administration of iron or placebo after 10 days or after 3 months of iron therapy . Among anemic infants a hemoglobin concentration less than 10.5 g/dL and duration of anemia of greater than 3 months were correlated with significantly lower motor and mental scores ( P less than .05 ) . Anemic infants failed specifically in language capabilities and body balance-coordination skills when compared with controls . These results , in a design in which intervening variables were closely controlled , suggest that when iron deficiency progresses to anemia , but not before , adverse influences in the performance of developmental tests appear and persist for at least 3 months despite correction of anemia with iron therapy . If these impairments prove to be long st and ing , prevention of iron deficiency anemia in early infancy becomes the only way to avoid them OBJECTIVE To report the prevalence rates and correlates for anaemia , iron deficiency ( ID ) and iron-deficiency anaemia ( IDA ) among Inuit preschool-aged children . DESIGN A cross-sectional study  assessed iron intake , demographic information , medical history , anthropometrics , Hb , ferritin , C-reactive protein and antibodies to Helicobacter pylori . SETTING Sixteen selected Inuit communities in Nunavut Territory , Canada . SUBJECTS Inuit ( n 388 ) aged 3 - 5 years r and omly recruited from communities . RESULTS Anaemia ( 3 - 4 years : Hb < 110 g/l ; 5 years : Hb < 115 g/l ) was prevalent in 16·8 % of children . The prevalence of ID ( ferritin < 12 μg/l ) was 18·0 % and that of IDA was 5·4 % . When ID was defined as ferritin < 10 μg/l , 10·8 % of children were iron deficient and 3·3 % had IDA . In multiple logistic regression , boys were more likely to be iron deficient ( OR = 2·28 , 95 % CI 1·17 , 8·25 ) , but no other risk factor emerged for ID . Three- to 4-year-olds were less likely than 5-year-olds to have anaemia from causes other than ID ( OR = 0·11 , 95 % CI 0·08 , 0·58 ) . Anaemia from other causes was more common among children residing in crowded homes ( OR = 2·30 , 95 % CI 1·37 , 12·31 ) and those treated for past-year ear infection ( OR = 1·35 , 95 % CI 1·05 , 7·21 ) . CONCLUSIONS The low prevalence of ID and IDA is encouraging , but efforts are still needed to reduce rates as they continue to be higher than general population rates . Household crowding and infections may contribute to anaemia and warrant further research In a prospect i ve cohort study of 196 infants from birth to age 15 mo , the relationship of iron status to psychomotor development , the effect of a short-term trial of oral iron or placebo , and the effect of longer-term oral iron therapy was assessed . Development was assessed with the Bayley Scale of Infant Development in anemic , nonanemic , iron-deficient , and control children . Anemic infants had significantly lower indices than did control or nonanemic , iron-deficient infants . Control infants and nonanemic , iron-deficient infants performed comparably . No difference between the effect of oral administration of iron or placebo was noted after 10 d or 3 mo of iron therapy . A hemoglobin concentration of less than 105 g/L and anemia duration greater than 3 mo were correlated with significantly lower motor and mental scores , suggesting that when iron deficiency progresses to anemia , adverse influences in the performance of developmental tests appear and persist , despite iron therapy Iron deficiency anaemia ( IDA ) is the most common nutritional deficiency in the world including developed and developing countries . Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia , anaemia and IDA are still major public health problems in these communities particularly among children . A r and omized , double-blind , placebo-controlled trial was conducted on 250 Orang Asli ( aboriginal ) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation ( 200,000 IU ) on iron status indices , anaemia and IDA status . The effect of the supplement was assessed after 3 months of receiving the supplements ; after a complete 3-day deworming course of 400 mg/day of albendazole tablets . The prevalence of anaemia was found to be high : 48.5 % ( 95 % CI = 42.3 , 54.8 ) . Moreover , 34 % ( 95 % CI = 28.3 , 40.2 ) of the children had IDA , which accounted for 70.1 % of the anaemic cases . The findings showed that the reduction in serum ferritin level and the increments in haemoglobin , serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group ( p < 0.01 ) . Moreover , a significant reduction in the prevalence of IDA by almost 22 % than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3 % reduction among children in the placebo group . In conclusion , vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children . Hence , providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities Laboratory tests used in the diagnosis of iron status lack specificity in defining iron deficiency anaemia ( IDA ) and anaemia of inflammation ( AI ) . The  serum transferrin receptor ( sTfR ) may provide more information in this regard . The iron status of 561 pre‐school children was determined and classified using the conventional measurements . The value of the concentration of sTfR , the ratio of sTfR ( µg/ml ) to LogSF ( µg/l ) ( TfR‐Index ) , and the Log of the ratio of sTfR ( µg/l ) to SF ( µg/l ) − ( LogTfR : Fer ratio ) , in the classification of the iron status were determined by comparing their distributions across the classification of iron status . Although there were significant differences in sTfR and TfR‐Index across the categories of iron status , there was considerable overlap . All subjects with iron deficiency had LogTfR : Fer ratio > 2·55 , whereas in all subjects classified as AI it was < 2·55 , thus clearly separating the two . The LogTfR : Fer ratio was not able to exclude IDA in the presence of inflammation . However , in cases of combined IDA and AI the LogTfR : Fer ratio was < 2·55 but increased to > 2·55 after resolution of the inflammation . This novel method of calculating the LogTfR : Fer ratio may provide a more precise classification of the iron status of children
REVIEW ER 'S CONCLUSIONS There is no convincing evidence that iron treatment of young children with IDA has an effect on psychomotor development discernable within 5 - 11 days .
The effect of longer term treatment remains unclear but the data would be compatible with clinical ly significant benefit .
BACKGROUND Iron deficiency and iron deficiency anaemia ( IDA ) are common in young children .
It has been suggested that the lack of iron may have important effects on children 's psychomotor development and cognitive function .
OBJECTIVES To determine the effects of iron therapy on psychomotor development and cognitive function in iron deficient children less than 3 years of age .