The proposed study will determine if iron therapy can correct rhe developmental deficits and behavioral abnormalities associated with iron deficiency anemia in infancey. The four aims of the project are: 1) to determine the level of iron depletion at which infant behavior is adversely affected, 2) to determine if there are differences between injectable and oral iron in behavioral effects, 3) to determine if iron therapy can completely correct the deficits, and 4) to confirm the specific pattern of behavioral disturbances observed in iron deficient anemic infants in our first study. The research design is a double-blind randomized controlled study of the short- and long-term behavioral and developmental effects of intramuscular and oral iron treatment. Two hundred one- to two-year old infants will be studies, 60 with iron deficiency anemia, 60 with iron deficiency with intermediate hemoglobin values, and 80 who are non-anemic, divided equally into iron depleted and iron replete groups. Their behavior and development will be assessed using sensitive quantitative behavior measures as well as overall tests of infant intelligence. To identify the level of iron depletion at which iron deficiency impairs infant development (Aim 1), pretreatment comparisons will be made in the groups of infants, whose iron status corresponds to the physiologic progression involved in becoming anemic from lack of iron. To accomplich (Aim 2,) the development and behavior of iron deficient infants treated with intramuscular iron will be compared to that of similar groups treated with oral iron, before treatment, after one week and after three months. Iron deficient infants will be compared with an iron replete control group before and after all babies become iron replete to determine if iron therapy can completely correct any behavioral deficits (Aim 3). Finally, (Aim 4) the study will confirm our previous results which demonstrated a specific pattern of impaired cognitive functions and a strong relationship between abnormal behavior and poor developmental test performance in iron deficient anemic infants. The results will guide practical pediatric and public health dexisions about preventive strategies, screening priorities, the level of iron deficiency requiring treatment, and the mode of therapy for iron deficiency anemia, the most common nutritional disorder in the world.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Modified Research Career Development Award (K04)
Project #
5K04HD000509-03
Application #
3073080
Study Section
Human Development and Aging Subcommittee 1 (HUD)
Project Start
1983-03-01
Project End
1988-02-29
Budget Start
1985-03-01
Budget End
1986-02-28
Support Year
3
Fiscal Year
1985
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
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Lozoff, B (1988) Behavioral alterations in iron deficiency. Adv Pediatr 35:331-59
Lozoff, B; Brittenham, G M (1987) Behavioral alterations in iron deficiency. Hematol Oncol Clin North Am 1:449-64
Lozoff, B; Brittenham, G M; Wolf, A W et al. (1987) Iron deficiency anemia and iron therapy effects on infant developmental test performance. Pediatrics 79:981-95
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Wolf, A W; Lozoff, B (1985) A clinically interpretable method for analyzing the Bayley Infant Behavior Record. J Pediatr Psychol 10:199-214
Lozoff, B; Wolf, A W; Urrutia, J J et al. (1985) Abnormal behavior and low developmental test scores in iron-deficient anemic infants. J Dev Behav Pediatr 6:69-75
Lozoff, B; Wolf, A W; Davis, N S (1985) Sleep problems seen in pediatric practice. Pediatrics 75:477-83