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Published on: May 4, 2020
Iron deficiency and common neurodevelopmental disorders-A scoping review
Scout McWilliams1, Ishmeet Singh1, Wayne Leung1
1H-Behaviours Research Lab (previously Sleep/Wake-Behaviour Research Lab), BC Children's Hospital Research Institute, Vancouver, Canada.
Insights
Iron deficiency is linked to neurodevelopmental disorders like ADHD, ASD, and FASD in children and adolescents. Iron supplementation shows promise for ADHD but needs more research for ASD and FASD.
Area of Science:
- Neuroscience
- Pediatrics
- Nutritional Science
Background:
- Iron deficiency plays a role in neurodevelopmental disorders, both in initiating risk and aggravating existing conditions.
- While its impact is known in early life, the comprehensive association in childhood and adolescence remains underexplored.
- This review focuses on the link between iron deficiency and common neurodevelopmental disorders during these critical developmental stages.
Purpose of the Study:
- To investigate the association between iron deficiency and Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Fetal Alcohol Spectrum Disorders (FASD) in children and adolescents.
- To evaluate the efficacy of iron supplementation in improving outcomes for these neurodevelopmental disorders.
Main Methods:
- A scoping review of studies published between 1994 and 2021 was conducted.
- Searches were performed in four biomedical databases using keywords related to iron deficiency and the specified neurodevelopmental disorders.
- Inclusion criteria required quantitative iron status determination and reporting of primary iron markers in association with ADHD, ASD, or FASD.
Main Results:
- For ADHD, a strong association with iron deficiency was found in most studies, with iron supplementation showing positive effects in treatment studies.
- For ASD, findings were mixed, with some studies showing an association and others not, and one trial found no behavioral benefits from iron supplementation.
- For FASD, studies indicated a link between iron deficiency and growth retardation in children with prenatal alcohol exposure.
Conclusions:
- Evidence supports screening for iron deficiency and considering supplementation for pediatric ADHD, based on current findings.
- Further research is needed to investigate the role of iron deficiency and supplementation in ASD and FASD.
- Standardizing study methodologies and population investigations is crucial for robustly comparing and substantiating evidence.
Background:
A wealth of human and experimental studies document a causal and aggravating role of iron deficiency in neurodevelopmental disorders. While pre-, peri-, and early postnatal iron deficiency sets the stage for the risk of developing neurodevelopmental disorders, iron deficiency acquired at later ages aggravates pre-existing neurodevelopmental disorders. Yet, the association of iron deficiency and neurodevelopmental disorders in childhood and adolescence has not yet been explored comprehensively. In this scoping review, we investigate 1) the association of iron deficiency in children and adolescents with the most frequent neurodevelopmental disorders, ADHD, ASD, and FASD, and 2) whether iron supplementation improves outcomes in these disorders.
Method:
Scoping review of studies published between 1994 and 2021 using "iron deficiency / iron deficiency anemia" AND "ADHD" OR "autism" OR "FASD" in four biomedical databases. The main inclusion criterion was that articles needed to have quantitative determination of iron status at any postnatal age with primary iron markers such as serum ferritin being reported in association with ADHD, ASD, or FASD.
Results:
For ADHD, 22/30 studies and 4/4 systematic reviews showed an association of ADHD occurrence or severity with iron deficiency; 6/6 treatment studies including 2 randomized controlled trials demonstrated positive effects of iron supplementation. For ASD, 3/6 studies showed an association with iron deficiency, while 3/6 and 1/1 systematic literature review did not; 4 studies showed a variety of prevalence rates of iron deficiency in ASD populations; 1 randomized controlled trial found no positive effect of iron supplementation on behavioural symptoms of ASD. For FASD, 2/2 studies showed an association of iron deficiency with growth retardation in infants and children with prenatal alcohol exposure.
Conclusion:
Evidence in favor of screening for iron deficiency and using iron supplementation for pediatric neurodevelopmental disorders comes primarily from ADHD studies and needs to be further investigated for ASD and FASD. Further analysis of study methodologies employed and populations investigated is needed to compare studies against each other and further substantiate the evidence created.
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