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Published on: January 19, 2024
Home intervention improves cognitive and social-emotional scores in iron-deficient anemic infants
Betsy Lozoff1, Julia B Smith, Katy M Clark
1Center for Human Growth and Development, Department of Pediatrics and Communicable Diseases, 300 N Ingalls, University of Michigan, Ann Arbor, MI 48109-5406, USA. blozoff@umich.edu
Insights
A home-based intervention improved cognitive and social-emotional development in infants with iron-deficiency anemia (IDA). While cognitive scores improved, social-emotional differences persisted between infants with IDA and non-anemic infants.
Area of Science:
- Pediatrics
- Developmental Psychology
- Nutritional Science
Background:
- Iron-deficiency anemia (IDA) in infants is linked to developmental and behavioral issues.
- These issues may persist even after iron therapy.
Purpose of the Study:
- To evaluate if a home-based intervention enhances the behavior and development of infants diagnosed with IDA.
- To compare outcomes between infants receiving intervention and those under surveillance.
Main Methods:
- Infants with IDA and non-anemic infants (6 and 12 months) received oral iron.
- Participants were randomized to a year of surveillance or a developmental intervention program.
- Cognitive, motor, and social-emotional development were assessed using Bayley Scales.
Main Results:
- Infants with IDA exhibited lower positive social-emotional behavior at baseline.
- The intervention group showed improved cognitive performance and social-emotional behavior compared to surveillance.
- Infants with IDA in the intervention group had developmental trajectories similar to non-anemic infants, but social-emotional deficits remained.
Conclusions:
- A home-based developmental intervention positively impacted cognitive and social-emotional scores in infants with IDA.
- Despite improvements, social-emotional disparities persisted between infants with and without IDA.
Background:
Iron-deficiency anemia (IDA) is associated with alterations in infant behavior and development that may not be corrected with iron therapy.
Objective:
To determine if a home-based intervention to foster child development improves behavior and development of infants with IDA.
Methods:
Infants with IDA and nonanemic infants aged 6 and 12 months were treated with oral iron and randomly assigned to a year of surveillance or intervention. Infants in the surveillance group were visited weekly, and information on iron intake, feeding, and health were recorded. Infants in the intervention were visited weekly, and the home visits included an hour-long program to foster child development by providing support to the mother-infant relationship. The number of infants enrolled was 128 (66 who received intervention) and 149 (70 intervention) at 6 and 12 months, respectively. Psychologists who were unaware of iron status and intervention assignment assessed infants' cognitive, motor, and social-emotional development (Bayley Scales) at the beginning, midpoint, and end of the year; 116 6-month-olds and 134 12-month-olds had at least 2 assessments. Hierarchical linear modeling was used to analyze change over time.
Results:
Infants with IDA, regardless of enrollment age, were rated as less positive in social-emotional behavior at baseline. There were significant interactions between iron status and intervention associated with change in cognitive performance and positive social-emotional behavior. Infants with IDA who received intervention had developmental trajectories comparable to those of nonanemic infants in the intervention and surveillance groups, but these infants did not catch up in social-emotional behavior. Infants with IDA who received surveillance showed less increase in cognitive scores and had declines in positive social-emotional ratings.
Conclusions:
Home-based intervention to foster child development improved cognitive and social-emotional scores in infants with IDA, but social-emotional differences remained between infants with IDA and those without IDA.
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