Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4-year-old children.
Study Goal
The researchers aimed to determine the effects of adjusting prenatal iron supplementation based on maternal iron stores and hemoglobin levels on children's behavioral development.
Results Summary
Prenatal iron supplementation improved child behavior when adjusted to maternal iron stores, with 80 mg/day benefiting children of mothers with low iron stores but worsening behavior in those with normal-high stores. Lower doses (20 mg/day) improved behavior in children of mothers with high iron stores. Executive functioning also improved with high doses in mothers with low iron stores.
Population
230 nonanaemic pregnant women in Tarragona, Spain, and their children after a 4-year follow-up.
Effective Dosage
20, 40, or 80 mg/day, adjusted based on maternal hemoglobin and iron stores.
Duration
From early pregnancy (before gestational week 12) until delivery.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Prenatal iron supplementation | increase | children's health and cognitive performance | children | - | improves | #1 |
Taking 80 mg/day of iron | increase | child behaviour | children whose mothers had low iron stores (SF < 15 µg/L) at GW12 | - | improved | #2 |
Taking 80 mg/day of iron | decrease | child behaviour | children whose mothers had normal-high iron stores (SF > 65 µg/L) at GW12 | - | worsened | #3 |
Taking 20 mg/day of iron | increase | behaviour | children whose mothers had SF > 65 µg/L in early pregnancy | - | improved | #4 |
high doses of prenatal iron | increase | executive functioning | children whose mothers had maternal baseline SF < 15 µg/L | - | improved | #5 |
Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores | decrease | behavioural problems | 4-year-old children | - | reduces | #6 |
Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4-year follow-up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110-130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15-65 µg/L), and normal-high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5-5 years and the Behaviour Rating Inventory of Executive Function-Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5-5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal-high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4-year-old children.