Effects of iron supplementation of low-birth-weight infants on cognition and behavior at 7 years: a randomized controlled trial
Effects of iron supplementation of low-birth-weight infants on cognition and behavior at 7 years: a randomized controlled trial
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DOI：
10.1038/pr.2017.235
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发表时间：
2018-01-01
影响因子：
3.6
通讯作者：
Domellof, Magnus
中科院分区：
文献类型：
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作者：
Berglund, Staffan K.;Chmielewska, Anna;Domellof, Magnus
背景：低出生体重儿(LBW)铁缺乏的风险增加，这与神经发育受损有关。我们假设低出生体重儿补充铁可以改善认知分数并减少行为问题，直到学龄。方法：我们随机选择285名低出生体重儿(2,000-2,500克)，在6周至6个月大期间每天补充0、1或2 mg/kg的铁。于7岁时，采用韦氏儿童智力量表(WISC-IV)和儿童行为量表(FTF)对205名儿童进行认知和行为方面的评估。结果：干预组在WISC-IV和FTF方面差异无统计学意义。而儿童外化问题量表得分差异有统计学意义(P=0.045)，支持辅助性儿童。当合并补充组时，他们的外化行为得分显著低于安慰剂组(中位数(四分位数范围)：44[34；51]vs.48.5[41；56]P=0.013)，他们的行为总分超过临床问题临界值的风险比(95%可信区间)为0.31(0.09~1.0)，P=0.054。结论：补充铁儿童的外化行为得分较低支持我们在3岁时的研究结果，提示补铁可能对行为功能有长期影响。
BACKGROUND: Low-birth-weight infants (LBW) are at an increased risk of iron deficiency that has been associated with impaired neurodevelopment. We hypothesized that iron supplementation of LBW infants improves cognitive scores and reduces behavioral problems until school age.METHODS: We randomized 285 marginally LBW (2,000-2,500 g) infants to receive 0, 1, or 2mg/kg/day of iron supplements from 6 weeks to 6 months of age. At 7 years of age, 205 participants were assessed regarding cognition using Wechsler Intelligence Scale for Children (WISC-IV) and behavior using the parental questionnaires Child Behavior Checklist (CBCL) and Five to Fifteen (FTF).RESULTS: There were no significant differences between the intervention groups in WISC-IV or FTF. However, the CBCL scores for externalizing problems were significantly different, in favor of supplemented children (P = 0.045). When combining the supplemented groups, they had significantly lower scores for externalizing behavior compared with placebo (median (interquartile range): 44 [34;51] vs. 48.5 [41;56] P = 0.013), and their risk ratio (95% confidence interval) for a total behavioral score above the cutoff for clinical problems was 0.31 (0.09-1.0), P = 0.054.CONCLUSION: Lower scores of externalizing behavior in supplemented children support our previous findings at 3 years, and suggest that iron supplementation may have long-lasting effects on behavioral functions.