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学科主题: 公共卫生
题名:
Iron therapy for improving psychomotor development and cognitive function in children under the age of three with iron deficiency anaemia
作者: Wang, Bo1; Zhan, Siyan2; Gong, Ting3; Lee, Liming3
关键词: Anemia, Iron-Deficiency [complications ; drug therapy] ; Ascorbic Acid [therapeutic use] ; Cognition [drug effects] ; Iron [therapeutic use] ; Psychomotor Performance [drug effects] ; Randomized Controlled Trials as Topic ; Time Factors ; Treatment Outcome ; Child ; Preschool ; Humans ; Infant
刊名: COCHRANE DATABASE OF SYSTEMATIC REVIEWS
发表日期: 2013
DOI: 10.1002/14651858.CD001444.pub2
期: 6
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: BRAIN IRON ; INFANTS ; SUPPLEMENTATION ; PERFORMANCE ; BEHAVIOR ; TRIALS ; SCORES ; MOTOR
英文摘要:

Background

Iron deficiency and iron deficiency anaemia (IDA) are common in young children. It has been suggested that the lack of iron may have deleterious effects on children′s psychomotor development and cognitive function. To evaluate the benefits of iron therapy on psychomotor development and cognitive function in children with IDA, a Cochrane review was carried out in 2001. This is an update of that review.

Objectives

To determine the effects of iron therapy on psychomotor development and cognitive function in iron deficient anaemic children less than three years of age.

Search methods

We searched the following databases in April 2013: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform (ICTRP). We also searched the reference lists of review articles and reports, and ran citation searches in the Science Citation Index for relevant studies identified by the primary search. We also contacted key authors.

Selection criteria

Studies were included if children less than three years of age with evidence of IDA were randomly allocated to iron or iron plus vitamin C versus a placebo or vitamin C alone, and assessment of developmental status or cognitive function was carried out using standardised tests by observers blind to treatment allocation.

Data collection and analysis

Two review authors independently screened titles and abstracts retrieved from the searches and assessed full-text copies of all potentially relevant studies against the inclusion criteria. The same review authors independently extracted data and assessed the risk of bias of the eligible studies. Data were analysed separately depending on whether assessments were performed within one month of beginning iron therapy or after one month.

Main results

We identified one eligible study in the update search that had not been included in the original review. In total, we included eight trials.

Six trials, including 225 children with IDA, examined the effects of iron therapy on measures of psychomotor development and cognitive function within 30 days of commencement of therapy. We could pool data from five trials. The pooled difference in pre-to post-treatment change in Bayley Scale Psychomotor Development Index (PDI) between iron and placebo groups was -1.25 (95% confidence interval (CI) -4.56 to 2.06, P value = 0.65; I-2 = 33% for heterogeneity, random-effects meta-analysis; low quality evidence) and in Bayley Scale Mental Development Index (MDI) was 1.04 (95% CI -1.30 to 3.39, P value = 0.79; I-2 = 31% for heterogeneity, random-effects meta-analysis; low quality evidence).

Two studies, including 160 randomised children with IDA, examined the effects of iron therapy on measures of psychomotor development and cognitive function more than 30 days after commencement of therapy. One of the studies reported the mean number of skills gained after two months of iron therapy using the Denver Developmental Screening Test. The intervention group gained 0.8 (95% CI -0.18 to 1.78, P value = 0.11, moderate quality of evidence) more skills on average than the control group. The other study reported that the difference in pre-to post-treatment change in Bayley Scale PDI between iron-treated and placebo groups after four months was 18.40 (95% CI 10.16 to 26.64, P value < 0.0001; moderate quality evidence) and in Bayley Scale MDI was 18.80 (95% CI 10.17 to 27.43, P value < 0.0001; moderate quality evidence).

Authors′ conclusions

There is no convincing evidence that iron treatment of young children with IDA has an effect on psychomotor development or cognitive function within 30 days after commencement of therapy. The effect of longer-term treatment remains unclear. There is an urgent need for further large randomised controlled trials with long-term follow-up.

语种: 英语
项目资助者: Peking University Health Science Center, China ; Chinese Academy of Medical Sciences, China ; Ministry of Education, China
WOS记录号: WOS:000321124000007
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/58621
Appears in Collections:北京大学公共卫生学院_期刊论文

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作者单位: 1.Chinese Acad Med Sci, Hlth Sci Popularizat Res Ctr, Beijing 100730, Peoples R China
2.Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Ctr Evidence Based Med & Clin Res, Beijing 100191, Peoples R China
3.Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing 100191, Peoples R China

Recommended Citation:
Wang, Bo,Zhan, Siyan,Gong, Ting,et al. Iron therapy for improving psychomotor development and cognitive function in children under the age of three with iron deficiency anaemia[J]. COCHRANE DATABASE OF SYSTEMATIC REVIEWS,2013(6).
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