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Effects of Daily Iron Supplementation on Motor Development and Brain Connectivity in Preterm Infants: A Diffusion
Mingyan Li1, Chai Ji1, Weifeng Xuan2
1Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
Iron status in preterm infants impacts motor development and brain connectivity. Early iron supplementation improved motor skills and brain structure, eliminating differences between iron-deficient and sufficient groups.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Pediatric Nutrition
Background:
- Preterm infants are at risk for iron deficiency, potentially affecting neurodevelopment.
- Iron status influences brain structural connectivity and motor development in early infancy.
Purpose of the Study:
- To investigate motor development and brain MRI changes in preterm infants based on iron status.
- To assess the efficacy of daily iron supplementation in promoting motor development.
Main Methods:
- 63 preterm infants were categorized into non-anemia/higher ferritin (NA-HF) and anemia/lower ferritin (A-LF) groups.
- MRI and Infant Neurological International Battery (INFANIB) were performed at 3 months; Peabody Developmental Motor Scales (PDMS) assessed motor skills at 6 months corrected age after iron supplementation.
- Iron supplementation of 2 mg/kg/day was administered for 6 months.
Main Results:
- The A-LF group showed lower serum ferritin and poorer INFANIB scores compared to the NA-HF group.
- Stronger cerebellum-thalamus structural connectivity was observed in the NA-HF group.
- Decreased brain structural connectivity correlated positively with motor development scores (PDMS).
- Post-supplementation, no significant differences in iron status or motor skills were found between groups.
Conclusions:
- Early postnatal iron status is linked to motor development and brain structural connectivity in preterm infants.
- Reduced brain structural connectivity is associated with motor delays.
- 6 months of iron supplementation normalized iron status and motor abilities, eliminating initial group differences.
Abstract:
Objectives: The aim of the study is to demonstrate the characteristic of motor development and MRI changes of related brain regions in preterm infants with different iron statuses and to determine whether the daily iron supplementation can promote motor development for preterm in early infancy. Methods: The 63 preterm infants were grouped into non-anemia with higher serum ferritin (NA-HF) group and anemia with lower serum ferritin (A-LF) group according to their lowest serum Hb level in the neonatal period as well as the sFer at 3 months old. Forty-nine participants underwent MRI scans and Infant Neurological International Battery (INFANIB) at their 3 months. At 6 months of corrected age, these infants received the assessment of Peabody Developmental Motor Scales (PDMS) after 2 mg/kg/day iron supplementation. Results: In total, 19 preterm infants were assigned to the NA-HF group while 44 preterm infants to the A-LF groups. The serum ferritin (sFer) level of the infants in A-LF group was lower than that in NA-HF group (44.0 ± 2.8 mg/L vs. 65.1 ± 2.8 mg/L, p < 0.05) and was with poorer scores of INFANIB (66.8 ± 0.9 vs. 64.4 ± 0.6, p < 0.05) at 3 months old. The structural connectivity between cerebellum and ipsilateral thalamus in the NA-HF group was significantly stronger than that in the A-LF group (n = 17, 109.76 ± 23.8 vs. n = 32, 70.4 ± 6.6, p < 0.05). The decreased brain structural connectivity was positively associated with the scores of PDMS (r = 0.347, p < 0.05). After 6 months of routine iron supplementation, no difference in Hb, MCV, MCHC, RDW, and sFer was detected between A-LF and NA-HF groups as well as the motor scores of PDMS-2 assessments. Conclusion: Iron status at early postnatal period of preterm infant is related to motor development and the enrichment of brain structural connectivity. The decrease in brain structural connectivity is related to the motor delay. After supplying 2 mg/kg of iron per day for 6 months, the differences in the iron status and motor ability between the A-LF and NA-HF groups were eliminated.
