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Growth and development in children with sickle-cell trait. A prospective study of matched pairs
Insights
Children with sickle-cell trait (Hb AS) show no significant deficits in physical growth or cognitive development compared to children without the trait (Hb AA). This study highlights the importance of rigorous matching in research.
Area of Science:
- Pediatrics
- Genetics
- Developmental Biology
Background:
- Sickle-cell trait (Hb AS) is a common inherited blood disorder.
- Concerns exist regarding potential impacts of Hb AS on child development.
- Rigorous research methods are crucial for accurate comparisons.
Purpose of the Study:
- To investigate the effects of sickle-cell trait (Hb AS) on physical growth.
- To assess the impact of sickle-cell trait (Hb AS) on cognitive development in children.
- To compare growth and cognitive outcomes between children with Hb AS and Hb AA.
Main Methods:
- Prospective investigation of 50 matched pairs of Black children.
- Matching criteria included sex, birth date, birth weight, gestational age, Apgar score, and socioeconomic status.
- Evaluations at 3-5 years included anthropometric measurements and standardized cognitive tests (McCarthy Scales, PPVT) by blinded assessors.
Main Results:
- No statistically significant differences were observed in height, weight, head circumference, skin-fold thickness, arm muscle area, or bone age between Hb AS and Hb AA groups.
- Cognitive assessments using the McCarthy Scales of Children's Abilities and the Peabody Picture Vocabulary Test showed no significant differences.
- These findings indicate no developmental deficits associated with sickle-cell trait in this cohort.
Conclusions:
- Children with sickle-cell trait (Hb AS) do not exhibit deficits in physical growth or cognitive development during early childhood.
- The study underscores the necessity of employing stringent matching protocols in clinical research to avoid confounding variables.
- Results support the understanding that sickle-cell trait is generally benign regarding developmental outcomes in childhood.
Abstract:
To ascertain if sickle-cell trait (Hb AS) impairs physical growth and cognitive development, we prospectively investigated 50 matched pairs of black children. For each child with Hb AS, an Hb AA child was matched at birth for sex, birth date, birth weight, gestational age, five-minute Apgar score and socioeconomic status. Between the ages of three and five years, the members of each matched pair were evaluated, with one month of one another, by persons "blind" to the hemoglobin genotype. Twelve outcome measurements were obtained at evaluation: height, weight, head circumference, skin-fold thickness, cross-sectional area of arm muscle, bone age, five scores of the McCarthy Scales of Children's Abilities, and the Peabody Picture Vocabulary Test. There were no statistically significant differences in these measurements favoring the AA group. The results show that children with sickle-cell trait in this age group have no deficits in standard measurements of growth and development and emphasize the importance of rigorous methods when clinical groups are assembled and compared.