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Published on: May 4, 2020
Effect of iron supplementation on mental and motor development in children: systematic review of randomised
Hps Sachdev1, Tarun Gera, Penelope Nestel
1SL Jain Hospital, New Delhi 110 052, India. hpssachdev@hotmail.com
Insights
Iron supplementation offers a modest boost to children's mental development, particularly for older children and those with anemia. However, it shows no significant impact on motor skills or the mental development of very young children.
Area of Science:
- Pediatrics
- Nutritional Science
- Developmental Psychology
Background:
- Iron deficiency anemia is a prevalent global health issue affecting child development.
- Adequate iron intake is crucial for cognitive and motor function.
- Previous studies on iron supplementation's developmental effects have yielded mixed results.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) assessing the impact of iron supplementation on children's mental and motor development.
- To synthesize evidence regarding the efficacy of iron interventions in improving developmental outcomes.
Main Methods:
- A comprehensive search of electronic databases, personal files, and conference proceedings was conducted.
- RCTs involving oral or parenteral iron, fortified foods, and developmental assessments were included.
- Meta-analysis using random-effects models was employed to pool outcome data.
Main Results:
- Iron supplementation showed a modest positive effect on overall mental development scores (SMD 0.30).
- Significant benefits were observed for intelligence quotient scores in children aged 8 years and older (SMD 0.41).
- No significant effect was found on motor development scores (SMD 0.09) or mental development in children under 27 months.
Conclusions:
- Iron supplementation provides a modest improvement in mental development, especially in older children and those with pre-existing anemia.
- The benefits are most pronounced in cognitive assessments, such as intelligence tests.
- Evidence does not support iron supplementation for enhancing motor development or the mental development of very young children.
Objective:
To evaluate the effect of iron supplementation on mental and motor development in children through a systematic review of randomised controlled trials (RCTs).
Data Sources:
Electronic databases, personal files, hand search of reviews, bibliographies of books, abstracts and proceedings of international conferences.
Review Methods:
RCTs with interventions that included oral or parenteral iron supplementation, fortified formula milk or cereals were evaluated. The outcomes studied were mental and motor development scores and various individual development tests employed, including Bayley mental and psychomotor development indices and intelligence quotient.
Results:
The pooled estimate (random effects model) of mental development score standardised mean difference (SMD) was 0.30 (95% confidence interval (CI) 0.15 to 0.46, P<0.001; P<0.001 for heterogeneity). Initial anaemia and iron-deficiency anaemia were significant explanatory variables for heterogeneity. The pooled estimate of Bayley Mental Development Index (weighted mean difference) in younger children (<27 months old) was 0.95 (95% CI -0.56 to 2.46, P=0.22; P=0.016 for heterogeneity). For intelligence quotient scores (> or =8 years age), the pooled SMD was 0.41 (95% CI 0.20 to 0.62, P<0.001; P=0.07 for heterogeneity). There was no effect of iron supplementation on motor development score (SMD 0.09, 95% CI -0.08 to 0.26, P=0.28; P=0.028 for heterogeneity).
Conclusions:
Iron supplementation improves mental development score modestly. This effect is particularly apparent for intelligence tests above 7 years of age and in initially anaemic or iron-deficient anaemic subjects. There is no convincing evidence that iron treatment has an effect on mental development in children below 27 months of age or on motor development.
