title: Iron-deficiency anemia in infancy and social emotional development in preschool-aged Chinese children.
abstract: OBJECTIVE
  We aimed to compare affect and behavior of 3 groups of nonanemic 4-year-old children: children with iron-deficiency anemia (IDA) in infancy whose anemia was not corrected before 24 months (chronic IDA) (n = 27); children with IDA in infancy whose anemia was corrected before 24 months (corrected IDA) (n = 70); and children who were nonanemic in infancy and at 24 months (n = 64).
  
  
  METHODS
  Mother and child dyads were invited to a local clinic room. Children's social referencing, wariness, frustration-tolerance behavior, and affect were observed during a set of situations encountered in the laboratory, including free play, stranger approach, novel toy, and delay of gratification. The whole procedure was videotaped. The children's affective and behavioral displays were coded by using a time-sampling (5-second segments) code scheme. Iron status of children was determined on the basis of hemoglobin concentration measured with the cyanomethemoglobin method in blood samples obtained by fingerstick in infancy and at the ages of 24 months and 4 years.
  
  
  RESULTS
  Children who had chronic IDA in infancy displayed less positive affect, less frustration tolerance, more passive behavior, and more physical self-soothing in the stranger approach and delay of gratification. In contrast, the behavior and affect of children whose anemia was corrected before the age of 24 months were comparable to those of children who were nonanemic throughout infancy.
  
  
  CONCLUSIONS
  The results point to the potential benefits of preventing iron deficiency in infancy and treating it before it becomes chronic or severe.
authors.affiliation: Chinese Centers for Disease Control and Prevention, Beijing, China.
authors.forename: Suying
authors.initials: S
authors.lastname: Chang
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Yuying
authors.initials: Y
authors.lastname: Wang
authors.forename: Inge D
authors.initials: ID
authors.lastname: Brouwer
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
authors.forename: Betsy
authors.initials: B
authors.lastname: Lozoff
authors.forename: Chunming
authors.initials: C
authors.lastname: Chen
mesh_terms: D000223:Adaptation, Psychological; D000342:Affective Symptoms / Q000453:epidemiology* / Q000208:ethnology* / Q000517:prevention & control; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology*; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000208:ethnology* / Q000517:prevention & control; D002675:Child, Preschool; D002681:China; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003906:Developing Countries; D019587:Dietary Supplements; D005260:Female; D005639:Frustration; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D015994:Incidence; D007223:Infant; D007266:Inhibition, Psychological; D019266:Iron, Dietary / Q000008:administration & dosage; D008137:Longitudinal Studies; D008297:Male; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D012016:Reference Values; D012307:Risk Factors; D012653:Self Stimulation; D012917:Social Adjustment; D012919:Social Behavior; D012931:Social Environment
chemical_list: D019266:Iron, Dietary