Impact Of 6 To 8 Weeks Iron Therapy On Psychomotor And Cognitive Development In Children Less Than 30 Months Old With Mild To Moderated Iron Deficiency Anemia (IDA); Observational Analytical Study

Abstract

Background:Iron deficiency anemia (IDA) is very common in young Indian children. Studies have suggested that IDA may affect a child’s motor and cognitive function adversely with long-term consequences. We want to evaluate the benefit of iron therapy on psychomotor development and cognitive function in children 6-30 months of age with IDA.

Objective: To determine whether IDA affects cognitive and motor development in children and its reversibility after 6-8 weeks of iron therapy and whether the age of occurrence affects the outcome.

Methods and Material: In this prospective cohort study of 40 children [20 each in group A (6-18 months) and group B (19-30 months)] attending the well-baby clinic with mild to moderate microcytic hypochromic anemia (haemoglobin 7-11mg/dl) and ferritin <12ng/ml were recruited by convenience sampling. Motor developmental quotient (DMoQ) and Mental developmental quotient (DMeQ) were assessed by DASII (Developmental Assessment Scale for Indian Infants) at baseline. After 6-8 weeks of iron therapy haemoglobin, ferritin, and the DASII were re-assessed in each group and compared.

Results: Baseline mean haemoglobin in group A was comparable[9.295 (±0.098)]  with Group B [8.688 (±0.881)] (p=0.065) which increased to 10.184 (±0.104) and 9.706 (±0.843) post-treatment respectively. (p<0.001). Both pretreatment DMoQand DMeQ in group A were significantly lower(81.7505±5.47536 and  80.2316(±10.18296)  than in group B (88.3338±4.02698 and 88.6081±3.52993) respectively. (p<0.001).  Post-treatment the DMoQ and DMeQ of group A increased to 89.5142 (±6.33824) and 87.1279(±9.41449) respectively. (p <0.001). The DMoQ and DMeQ of group B increased to 91.1719(±3.35625)  and 91.3969(±2.57973) post-treatment respectively. (p <0.001). Posttreatment Hemoglobin, S.ferritin, DMoQ and DMeQ achieved in both groups were similar (p= 0.137, p=0.203, p=0.311 and p= 0.101 respectively).

Conclusions: Mild to moderate iron-deficiency anemia impairs Psychomotor and Mental development in Children <30 months. IDA affects DMoQ and DMeQ in children younger than 18 months of age more severely than in older children. The DMoQ and DMeQ improved after 6 to 8 weeks of iron therapy in both the groups but they remained below normal.  Initial DMoQ and DMeQ score differences between study groups were not found to be significant after 6-8 weeks of oral iron treatment. Prevention, early recognition of IDA, and treatment with normalization of hemoglobin along with developmental support may be more beneficial.