ABSTRACT

Objective

To determine whether iron deficiency in infancy is associated with sluggish cognitive tempo (SCT) or attention-deficit/hyperactive-impulsive (AD-HI) symptoms in childhood and adolescence, and whether such behaviors contribute concurrently and predictively to lower verbal and mathematical abilities.

Method

Chilean children (N = 959; 50% male, of Spanish or indigenous descent from working-class backgrounds) were rated by mothers for SCT or AD-HI symptoms at ages 5, 10, and 16 years. Children completed standardized tests assessing verbal and mathematical abilities at ages 5, 10, and 16. At ages 12 and 18 months, children were assessed for iron deficiency.

Results

Adjusting for a comprehensive panel of covariates, greater severity of iron deficiency in infancy was associated with more frequent SCT and AD-HI symptoms at all ages studied. Most effects of iron deficiency on children’s verbal and math skills were indirect, mediated through AD-HI behaviors. Children’s AD-HI symptoms related to lower verbal and math test scores within age and across age.

Conclusions

The long-term associations found between infant iron deficiency and SCT and AD-HI behaviors suggest that the neurodevelopmental alterations that stem from postnatal iron deficiency might play an etiological role in the development of ADHD. Screening for early-life nutritional deficiencies among children with SCT or ADHD symptoms might prove useful, and behavioral screening of children with a history of iron deficiency seems warranted. Interventions that support brain development after early nutritional deprivation also would be beneficial.

中文翻译：

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婴儿期缺铁、儿童和青春期认知节奏迟缓和多动症症状

摘要

客观的

确定婴儿期缺铁是否与儿童和青春期认知节奏迟缓 (SCT) 或注意力缺陷/多动冲动 (AD-HI) 症状有关，以及这些行为是否会同时和预测地导致语言和数学能力下降。

方法

智利儿童（N = 959；50% 为男性，来自工人阶级背景的西班牙人或土著后裔）在 5、10 和 16 岁时由母亲评定为 SCT 或 AD-HI 症状。儿童在 5 岁、10 岁和 16 岁时完成了评估语言和数学能力的标准化测试。在 12 个月和 18 个月大时，对儿童进行了缺铁性评估。

结果

针对一组综合的协变量进行调整后，婴儿期铁缺乏症的严重程度与所研究的所有年龄段更频繁的 SCT 和 AD-HI 症状相关。缺铁对儿童语言和数学技能的大部分影响是间接的，通过 AD-HI 行为进行调节。儿童的 AD-HI 症状与年龄内和跨年龄的较低语言和数学测试分数有关。

结论

婴儿缺铁与 SCT 和 AD-HI 行为之间的长期关联表明，出生后缺铁引起的神经发育改变可能在 ADHD 的发展中发挥病因学作用。对有 SCT 或 ADHD 症状的儿童进行生命早期营养缺乏筛查可能证明是有用的，并且对有缺铁病史的儿童进行行为筛查似乎是必要的。在早期营养剥夺后支持大脑发育的干预措施也将是有益的。