Iron therapy for improving psychomotor development and cognitive function in children under the age of three with iron deficiency anaemia

Background Iron deficiency and iron deficiency anaemia (IDA) are common in young children. It has been suggested that the lack of iron may have deleterious effects on children's psychomotor development and cognitive function. To evaluate the benefits of iron therapy on psychomotor development and cognitive function in children with IDA, a Cochrane review was carried out in 2001. This is an update of that review. Objectives To determine the effects of iron therapy on psychomotor development and cognitive function in iron deficient anaemic children less than three years of age. Search methods We searched the following databases in April 2013: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform (ICTRP). We also searched the reference lists of review articles and reports, and ran citation searches in the Science Citation Index for relevant studies identified by the primary search. We also contacted key authors. Selection criteria Studies were included if children less than three years of age with evidence of IDA were randomly allocated to iron or iron plus vitamin C versus a placebo or vitamin C alone, and assessment of developmental status or cognitive function was carried out using standardised tests by observers blind to treatment allocation. Data collection and analysis Two review authors independently screened titles and s retrieved from the searches and assessed full‐text copies of all potentially relevant studies against the inclusion criteria. The same review authors independently extracted data and assessed the risk of bias of the eligible studies. Data were analysed separately depending on whether assessments were performed within one month of beginning iron therapy or after one month. Main results We identified one eligible study in the update search that had not been included in the original review. In total, we included eight trials. Six trials, including 225 children with IDA, examined the effects of iron therapy on measures of psychomotor development and cognitive function within 30 days of commencement of therapy. We could pool data from five trials. The pooled difference in pre‐ to post‐treatment change in Bayley Scale Psychomotor Development Index (PDI) between iron and placebo groups was ‐1.25 (95% confidence interval (CI) ‐4.56 to 2.06, P value = 0.65; I2 = 33% for heterogeneity, random‐effects me