Low-Dose Iron Supplementation in Infancy Modestly Increases Infant Iron Status at 9 Mo without Decreasing Growth or Increasing Illness in a Randomized Clinical Trial in Rural China

Published on Mar 1, 2016in Journal of Nutrition4.416
路 DOI :10.3945/jn.115.223917
Betsy Lozoff45
Estimated H-index: 45
(UM: University of Michigan),
Yaping Jiang7
Estimated H-index: 7
+ 11 AuthorsMing Li6
Estimated H-index: 6
BACKGROUND: Previous trials of iron supplementation in infancy did not consider maternal iron supplementation. OBJECTIVE: This study assessed effects of iron supplementation in infancy and/or pregnancy on infant iron status illnesses and growth at 9 mo. METHODS: Enrollment occurred from December 2009 to June 2012 in Hebei China. Infants born to women in a pregnancy iron supplementation trial were randomly assigned 1:1 to iron [ approximately 1 mg Fe/(kg . d) as oral iron proteinsuccynilate] or placebo from 6 wk to 9 mo excluding infants with cord ferritin /=2 abnormal iron measures) or body iron 60% of infants still had ID at 9 mo. Receiving more bottles of iron in infancy was associated with better infant iron status at 9 mo but only among iron-supplemented infants whose mothers were also iron supplemented (i.e. the iron/iron group). There were no group differences in hospitalizations or illnesses and no adverse effects on growth overall or among infants who were iron sufficient at birth. CONCLUSIONS: Iron supplementation in Chinese infants reduced ID at 9 mo without adverse effects on growth or illness. Effects of iron supplementation in pregnancy were observed only when higher amounts of iron were distributed in infancy. This trial was registered at as NCT00613717. (c) 2016 American Society for Nutrition.
  • References (38)
  • Citations (7)
馃摉 Papers frequently viewed together
49 Citations
17 Citations
10 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Gengli Zhao (PKU: Peking University)H-Index: 4
#2Guobin Xu (PKU: Peking University)H-Index: 3
Last. Betsy Lozoff (UM: University of Michigan)H-Index: 45
view all 12 authors...
Background: Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status. Objective: The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status. Methods: Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at 鈮20 wk gestation, aged 鈮18 y, and with hemoglobin 鈮100 g/L were randomly assigned 1:1 to receive daily iron (300 mg ferrous sulfat...
20 CitationsSource
#1Juan Pablo Pe帽a-Rosas (WHO: World Health Organization)H-Index: 17
#2Luz Maria De-Regil (Micronutrient Initiative)H-Index: 20
Last. Therese Dowswell (University of Liverpool)H-Index: 33
view all 4 authors...
Background Iron and folic acid supplementation has been the preferred intervention to improve iron stores and prevent anaemia among pregnant women, and it is thought to improve other maternal and birth outcomes. Objectives To assess the effects of daily oral iron supplements for pregnant women, either alone or in conjunction with folic acid, or with other vitamins and minerals as a public health intervention in antenatal care. Search methods We searched the Cochrane Pregnancy and Childbirth Grou...
182 CitationsSource
#1Marian S. McDonagh (OHSU: Oregon Health & Science University)H-Index: 19
#2Ian Blazina (OHSU: Oregon Health & Science University)H-Index: 17
Last. Christina Bougatsos (OHSU: Oregon Health & Science University)H-Index: 27
view all 5 authors...
BACKGROUND AND OBJECTIVES: Supplementation and screening for iron-deficiency anemia (IDA) in young children may improve growth and development outcomes. The goal of this study was to review the evidence regarding the benefits and harms of screening and routine supplementation for IDA for the US Preventive Services Task Force. METHODS: We searched Medline and Cochrane databases (1996鈥揂ugust 2014), as well as reference lists of relevant systematic reviews. We included trials and controlled observa...
32 CitationsSource
#1Mari S. Golub (UC Davis: University of California, Davis)H-Index: 32
#2Casey E. Hogrefe (California National Primate Research Center)H-Index: 8
Last. John M. Higgins (Harvard University)H-Index: 31
view all 4 authors...
Most human physiologic set points like body temperature are tightly regulated and show little variation between healthy individuals. Red blood cell (RBC) characteristics such as hematocrit and mean cell volume are stable within individuals but can vary by 20% from one healthy person to the next. The mechanisms for the majority of this inter-individual variation are unknown and do not appear to involve common genetic variation. Here, we show that environmental conditions present during developmen...
10 CitationsSource
#1Magnus Domell枚f (Ume氓 University)H-Index: 32
#2Christian BraeggerH-Index: 33
Last. Johannes B. van Goudoever (VU: VU University Amsterdam)H-Index: 24
view all 12 authors...
Iron deficiency (ID) is the most common micronutrient deficiency worldwide and young children are a special risk group because their rapid growth leads to high iron requirements. Risk factors assoc ...
142 CitationsSource
Background Maternal anemia and several complications of pregnancy can affect fetal iron acquisition.
22 CitationsSource
#1Sant-Rayn Pasricha (University of Melbourne)H-Index: 22
#2Emily Hayes (Monash Medical Centre)H-Index: 1
Last. Beverley-Ann Biggs (Royal Melbourne Hospital)H-Index: 35
view all 4 authors...
Summary Background About 47% of preschool children worldwide are anaemic. Daily oral iron supplementation is a commonly recommended intervention for treatment and prevention of anaemia, but the efficacy and safety of iron supplementation programmes is debated. Thus, we systematically reviewed the evidence for benefit and safety of daily iron supplementation in children aged 4鈥23 months. Methods We searched Scopus and Medline, from inception to Feb 5, 2013, WHO databases, theses repositories, gre...
84 CitationsSource
#1Gretchen A StevensH-Index: 46
#2Mariel M. Finucane (UCSF: University of California, San Francisco)H-Index: 25
Last. Majid Ezzati (Imperial College London)H-Index: 107
view all 9 authors...
Summary Background Low haemoglobin concentrations and anaemia are important risk factors for the health and development of women and children. We estimated trends in the distributions of haemoglobin concentration and in the prevalence of anaemia and severe anaemia in young children and pregnant and non-pregnant women between 1995 and 2011. Methods We obtained data about haemoglobin and anaemia for children aged 6鈥59 months and women of childbearing age (15鈥49 years) from 257 population-represent...
494 CitationsSource
#1Batool A. Haider (Harvard University)H-Index: 19
#2Ibironke Olofin (Harvard University)H-Index: 6
Last. Wafaie W. Fawzi (Harvard University)H-Index: 65
view all 6 authors...
Objectives To summarise evidence on the associations of maternal anaemia and prenatal iron use with maternal haematological and adverse pregnancy outcomes; and to evaluate potential exposure-response relations of dose of iron, duration of use, and haemoglobin concentration in prenatal period with pregnancy outcomes. Design Systematic review and meta-analysis Data sources Searches of PubMed and Embase for studies published up to May 2012 and references of review articles. Study selection criteria...
262 CitationsSource
#1Vesna Vucic (University of Belgrade)H-Index: 13
#2Cristiana Berti (University of Milan)H-Index: 15
Last. P. vantVeer (WUR: Wageningen University and Research Centre)H-Index: 51
view all 8 authors...
To evaluate the effect of iron intervention on physical growth in fetuses, infants, children, and adolescents up to 18 years of age, a systematic review with meta-analysis of randomized controlled trials (RCTs) was conducted. Structured electronic searches were conducted to February 2010 using MEDLINE, Embase, and the Cochrane Library databases. RCTs that included iron-fortified foods, iron-fortified formula, or iron supplements and in which height, weight, mid-arm circumference (MAC), head circ...
32 CitationsSource
Cited By7
#1Julie C. Lumeng (UM: University of Michigan)H-Index: 33
#1Julie C. Lumeng (UM: University of Michigan)H-Index: 2
Last. Betsy Lozoff (UM: University of Michigan)H-Index: 45
view all 9 authors...
Abstract Intraoral sucrose has analgesic effects in the newborn period. The hedonic and analgesic effects of sucrose overlap and hedonic response to sweet food is associated with adiposity. The potential association between the analgesic effects of intraoral sucrose in the newborn period and subsequent weight gain has not been examined. Healthy, term newborns received 25% intraoral sucrose or water prior to metabolic screen heel stick. Negative affect, quiet alert behavior, and sleepiness were c...
#2Emily C KeatsH-Index: 2
view all 5 authors...
Micronutrient deficiencies continue to be widespread among children under-five in low- and middle-income countries (LMICs), despite the fact that several effective strategies now exist to prevent them. This kind of malnutrition can have several immediate and long-term consequences, including stunted growth, a higher risk of acquiring infections, and poor development outcomes, all of which may lead to a child not achieving his or her full potential. This review systematically synthesizes the avai...
Optimized nutrition during the first 1000 days (from conception through the 2nd birthday) is critical for healthy development and a healthy life for the newborn. Pregnancy and the postpartum period are accompanied by physiological changes, increased energy needs, and changing requirements in the nutrients critical for optimal growth and development. Infants and toddlers also experience physiological changes and have specific nutritional needs. Food and nutrition experts can provide women of chil...
#1Ann M. WeberH-Index: 8
#2Marta Rubio-Codina (BID: Inter-American Development Bank)H-Index: 9
Last. Maureen M. BlackH-Index: 61
view all 16 authors...
Introduction Early childhood development can be described by an underlying latent construct. Global comparisons of children鈥檚 development are hindered by the lack of a validated metric that is comparable across cultures and contexts, especially for children under age 3鈥墆ears. We constructed and validated a new metric, the Developmental Score (D-score), using existing data from 16 longitudinal studies. Methods Studies had item-level developmental assessment data for children 0鈥48 months and longi...
#1Ajibola I. Abioye (Brown University)H-Index: 8
#2Emily A. McDonald (Brown University)H-Index: 6
Last. Jennifer F. Friedman (Brown University)H-Index: 30
view all 15 authors...
We evaluated the association between etiology of maternal anemia and iron status throughout infancy. Samples from a study designed to examine Praziquantel treatment during pregnancy were used (n鈥=鈥359). All women were infected with schistosomiasis and randomized to Praziquantel or placebo at 16鈥壜扁2 weeks鈥 gestation. Hemoglobin, serum ferritin (SF), soluble transferrin receptor (sTfR), hepcidin, C-reactive protein, and interleukin-6 were measured in maternal and infant blood. The relationship bet...
#1Reeta Bora (Assam Medical College)H-Index: 4
#2Sutharson Ramasamy (Assam Medical College)
Last. Raghavendra Rao (UMN: University of Minnesota)H-Index: 22
view all 5 authors...
AbstractObjective: To investigate the effects of iron supplementation from the second day after birth on 6-month hemoglobin (Hb), serum ferritin and motor development in infants at risk of early ir...
#1Leila M Larson (University of Melbourne)H-Index: 5
#2Julianne N Kubes (Emory University)
Last. Elizabeth L. Prado (UC Davis: University of California, Davis)H-Index: 13
view all 6 authors...
Author(s): Larson, Leila Margaret; Kubes, Julianne Nicole; Ramirez-Luzuriaga, Maria J; Khishen, Sarah; H Shankar, Anuraj; Prado, Elizabeth Leah | Abstract: In children under 5, a hemoglobin (Hb) cutoff of 11 g/dL is recommended by the World Health Organization to define anemia, yet few studies have examined whether this cut point accurately coincides with negative functional consequences. This systematic review and meta-analysis of iron intervention and observational studies aimed to clarify the...
#1Denise C. C. Santos (UM: University of Michigan)H-Index: 1
#2Rosa M. Angulo-Barroso (UM: University of Michigan)H-Index: 16
Last. Betsy Lozoff (UM: University of Michigan)H-Index: 45
view all 7 authors...
Poorer motor development is reported in infants with iron deficiency (ID). The role of timing, duration and severity is unclear. We assessed relations between ID timing, duration, and severity and gross motor scores, neurological integrity, and motor behavior quality at 9 months. Iron status was determined at birth and 9 months in otherwise healthy term Chinese infants. The 9-month motor evaluation included the Peabody Developmental Motor Scale (PDMS-2), Infant Neurological International Battery...
3 CitationsSource
#1Staffan Berglund (Ume氓 University)H-Index: 12
#2Anna Chmielewska (Ume氓 University)H-Index: 8
Last. Magnus Domell枚f (Ume氓 University)H-Index: 32
view all 7 authors...
Effects of iron supplementation of low-birth-weight infants on cognition and behavior at 7 years: a randomized controlled trial
6 CitationsSource
#1Staffan Berglund (UGR: University of Granada)H-Index: 12
#2Francisco J. Torres-Esp铆nola (UGR: University of Granada)H-Index: 6
Last. Cristina Campoy (UGR: University of Granada)H-Index: 32
view all 10 authors...
Both maternal Fe deficiency (ID) and being overweight or obese (Ow/Ob, BMI鈮25 kg/m 2 ) may negatively affect offspring brain development. However, the two risk factors correlate and their independent effects on infant neurodevelopment are unclear. PREOBE is a prospective observational study that included 331 pregnant Spanish women, of whom 166 had pre-gestational Ow/Ob. Fe status was analysed at 34 weeks and at delivery, and babies were assessed using Bayley III scales of neurodevelopment at 18 ...
10 CitationsSource