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Published on: January 31, 2022
Developmental profile in children with iron deficiency anemia and its changes after therapeutic iron supplementation
Saurabh Kumar Gupta1, Deepak Bansal, Prahbhjot Malhi
1Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Children with iron deficiency anemia (IDA) show developmental delays, particularly in academic and communication skills. Oral iron therapy significantly improves these developmental scores, though severe anemia and older age may predict poorer outcomes.
Area of Science:
- Pediatrics
- Hematology
- Developmental Psychology
Background:
- Iron deficiency anemia (IDA) is a prevalent condition in young children.
- IDA can negatively impact cognitive and developmental trajectories.
- Early identification and intervention are crucial for mitigating long-term effects.
Purpose of the Study:
- To assess the developmental status of children diagnosed with IDA.
- To evaluate the efficacy of iron supplementation in improving developmental outcomes.
- To identify predictors of suboptimal developmental outcomes in children with IDA.
Main Methods:
- Prospective study involving children aged 6 months to 5 years with confirmed IDA.
- Developmental assessment using the Developmental Profile II (DPII) with IQ equivalent (IQE) and fractional months differential (FMD) interpretation.
- Hematological parameters and iron studies were conducted before and after 3 months of iron therapy.
Main Results:
- Significant developmental delays were observed in children with IDA, most notably in academic and communication domains.
- Following iron supplementation, significant improvements in DPII scores were noted across all domains.
- Approximately half of the children (51.4%) showed a substantial gain in IQE scores (>= 10 points).
Conclusions:
- Children with IDA exhibit suboptimal developmental profiles.
- Oral iron therapy can lead to reversible developmental delays.
- Hemoglobin levels <= 7 g/dL and age > 24 months are predictive of poorer developmental outcomes.
Objective:
To evaluate the developmental profile of children with iron deficiency anemia (IDA) and the changes following iron supplementation.
Methods:
Study was conducted prospectively in a tertiary care teaching institution. Subjects were children aged 6 months to 5-years, with IDA, proven by hematological parameters and iron studies. Complete blood counts and iron studies were performed at the beginning and following 3-months therapy with iron. Simultaneously, development was assessed by Developmental profile II (DPII), which was interpreted using IQ equivalent (IQE) scores and 'fractional months differential' (FMD).
Results:
Thirty five children fulfilled predetermined inclusion criteria. The mean-age was 22.3+/-13.4 months. Majority (71.4%) had moderate, while 5 (14.3%), each had mild and severe anemia. Significant developmental delay was observed in iron deficient children. Maximum delay was observed in academic and communication domains. 6 (17.2%) failed developmental screening, with IQE scores of <70. Significant improvement in DPII scores was noticed following therapy. Although some gain in IQE scores was noticed in the majority (88.6%), significant improvement (e => 10-point gain) was observed in about half (51.4%). Interpretation of DPII by FMD revealed significant improvement in all the domains as well.
Conclusion:
Children with IDA have suboptimal developmental scores. The delayed development is variably reversible following oral iron therapy. Hb =< 7 g/dl and age >24 months predicts suboptimal outcome. FMD is a useful method of interpreting DPII.
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