Related Experiment Video
Updated: Nov 19, 2025
Quantitating Iron Transport Across the Mouse Placenta In Vivo Using Nonradioactive Iron Isotopes
Published on: May 10, 2022
Behavioral consequences at 5 y of neonatal iron deficiency in a low-risk maternal-infant cohort
Elaine K McCarthy1,2, Deirdre M Murray2,3, Jonathan O B Hourihane2,3,4
1Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
Insights
Neonatal iron deficiency is linked to lasting behavioral issues in high-risk children. Prioritizing iron interventions during pregnancy and infancy is crucial for preventing these neurologic consequences.
Area of Science:
- Neuroscience
- Pediatrics
- Nutritional Science
Background:
- Iron is vital for fetal brain development, but iron accretion can be affected by maternal and pregnancy factors.
- Long-term neurological effects of neonatal iron deficiency, particularly in healthy populations, are understudied.
Purpose of the Study:
- To investigate the association between neonatal iron deficiency and neurological development at ages 2 and 5 years.
Main Methods:
- Umbilical cord serum ferritin measured in the Cork BASELINE Birth Cohort.
- Neurological assessments (Bayley Scales, CBCL, KBIT) conducted at 2 and 5 years.
- Sensitivity analysis performed on a high-risk subgroup (n=306).
Main Results:
- No association found between neonatal iron deficiency and cognitive/behavioral outcomes in the general cohort (n=697).
- In a high-risk subgroup (12% with iron deficiency), no cognitive differences were observed.
- However, high-risk children with neonatal iron deficiency showed significantly higher internalizing and total problem behavior scores at 5 years.
Conclusions:
- Neonatal iron deficiency is associated with persistent behavioral problems in high-risk children.
- Interventions targeting fetal and neonatal iron status are recommended to prevent adverse neurological outcomes.
- Further research is warranted to confirm these findings in larger populations.
Background:
Iron is critical to the developing brain, but fetal iron accretion is compromised by several maternal and pregnancy-related factors. Little consideration has been given to the long-term neurologic consequences of neonatal iron deficiency, especially in generally healthy, low-risk populations.
Objective:
We aimed to investigate the association between neonatal iron deficiency and neurologic development at 2 and 5 y of age.
Design:
We measured umbilical cord serum ferritin concentrations in the prospective maternal-infant Cork BASELINE (Babies after SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints) Birth Cohort. Lifestyle and clinical data were collected from 15 weeks of gestation to 5 y of age. Standardized neurologic assessments were performed at 2 y [Bayley Scales of Infant Development/Child Behavior Checklist (CBCL)] and 5 y (Kaufman Brief Intelligence Test/CBCL).
Results:
Among 697 maternal-infant pairs, median (IQR) cord ferritin concentrations were 200.9 (139.0, 265.8) µg/L; 8% had neonatal iron deficiency (ferritin <76 µg/L). Using fully adjusted models, there was no association between neonatal iron deficiency and cognitive or behavioral outcomes at 2 or 5 y. We conducted an a priori sensitivity analysis in 306 high-risk children, selected using known risk factors for neonatal iron deficiency (smoking/obesity/cesarean section delivery/small-for-gestational age birth). In this high-risk subgroup, children with iron deficiency at birth (12%) had similar cognitive outcomes, but the behavioral assessments showed higher internalizing [9.0 (5.3, 12.0) compared with 5.0 (3.0, 10.0), P = 0.006; adjusted estimate (95% CI): 2.8 (0.5, 5.1), P = 0.015] and total [24.5 (15.3, 40.8) compared with 16.0 (10.0, 30.0), P = 0.009; adjusted estimate (95% CI): 6.6 (0.1, 13.1), P = 0.047] problem behavior scores at 5 y compared with those born iron sufficient.
Conclusions:
We have demonstrated lasting behavioral consequences of neonatal iron deficiency in high-risk children from our generally healthy, low-risk maternal-infant cohort. Although larger investigations are warranted, this study provides strong association data to suggest that interventions and strategies targeting the fetal and neonatal period should be prioritized for the prevention of iron deficiency and associated neurologic consequences.
Related Concept Videos
01:07Teratogenicity
01:29Drug Dosing: Infants and Children
00:57The Periodic Table and Organismal Elements