Impact Of Iron Deficiency In Early Life Stages On Childrenvs Motor Development:a Longitudinal Follow-up

Objectives:The development of motor ability has an important influence on the development of children's cognitive function,executive function,social communication,language and other abilities.Iron deficiency in early life can alter brain structxure(including myelin abnormalities and disorganized dendritic branches)and function(the synthesis and function of dopamine and other monoamine neurotransmitters),leading to motor disorders and behavioral abnormalities.Poor motor development in childhood or adolescence may be linked to iron deficiency in the infancies or even in the fetuses.But few studies have pinpointed the exact timing of iron deficiency,so it's impossible to pinpoint a critical period in the brain's iron dependence.Through long-term follow-up of children,we hope to clarify the impact of pre-and postnatal iron deficiency on children's motor development,and whether the motor damage caused by iron deficiency can be completely corrected by iron supplementation in the later stage,and explore the influence of family environment and other external factors on ehildren'5 motor ability development.Methods:A total of 114 infants bom from April 2010 to December 2011 in Fuyang district of Hangzhou were enrolled.Based on cord blood and 9-month iron status,subjects were divided into prenatal iron deficiency,postnatal iron deficiency and non-iron deficiency group.Peabody developmental Motor Scale and BOT2-simplified version were used to evaluate the motor capacity in infants and preschoolers at 9 months,18 months and 5 years,respectively.Parents are required to fill out the family socioeconomic status questionnaire at 9months.Hierarchical linear modeling(HLM)was used to investigate the trajectory of motor development with age,the influence of different timing of perinatal iron deficiency on children's motor development,and the differences(adjusted for possible confounding factors)in motor development in children with pre-or postnatal iron deficiency or non-iron deficiency in different family educational environment.Results:Children with prenatal iron deficiency had significantly lower scores of motor development compared with non-iron deficiency children(52.04 vs.54.05,?=-2.01,P=0.007),and that children with postnatal iron deficiency had similar scores of motor development compared with non-iron deficiency children,showing no significant difference(53.07 vs.54.05 ?=-0.98,P=0.180).Regardless of the maternal education status,prenatal iron deficiency children always had lower motor scores than non-iron deficiency children(49.86 vs.52.15 and 49.58 vs.51.58,p=-2.29,-2.00;P=0.031,0.049).Among the non-iron deficiency children,those whose mothers had a higher education level had higher motor scores compared with those whose mothers had a lower education level(52.45 vs.50.46,p=1.99,P=0.035).Conclusions:The development of motor of children with prenatal didn't catch up with their counterparts without iron deficiency after iron supplementation,indicating the importance of preventing iron deficiency in the fetus.The education level of the mother affects the motor development of the children,but only for the children without iron deficiency,suggesting that high maternal education level cannot improve the motor development of children with iron deficiency,but can better stimulate the motor development potential of non-iron deficiency children.