title: Iron Supplementation in Pregnancy or Infancy and Motor Development: A Randomized Controlled Trial.
abstract: OBJECTIVE
  Insufficient iron levels for optimal fetal and infant development is a concern during pregnancy and infancy. The goal of this study was to assess the effects of iron supplementation in pregnancy and/or infancy on motor development at 9 months.
  
  
  METHODS
  The study was a randomized controlled trial (RCT) of infancy iron supplementation linked to an RCT of pregnancy iron supplementation, conducted in Hebei, China. A total of 1482 infants were randomly assigned to receive placebo (n = 730) or supplemental iron (n = 752) from 6 weeks to 9 months. Gross motor development (assessed by using the Peabody Developmental Motor Scale, Second Edition, instrument) was the primary outcome. Neurologic integrity and motor quality were secondary outcomes.
  
  
  RESULTS
  Motor outcome was available for 1196 infants, divided into 4 supplementation period groups: (1) placebo in pregnancy/placebo in infancy (n = 288); (2) placebo in pregnancy/iron in infancy (n = 305); (3) iron in pregnancy/placebo in infancy (n = 298); and (4) iron in pregnancy/iron in infancy (n = 305). Using the Peabody Developmental Motor Scale, instrument, iron supplementation in infancy but not pregnancy improved gross motor scores: overall, P < .001; reflexes, P = .03; stationary, P < .001; and locomotion, P < .001. Iron supplementation in infancy improved motor scores by 0.3 SD compared with no supplementation or supplementation during pregnancy alone. Effects of iron supplementation in infancy alone were similar to effects with iron in both pregnancy and infancy.
  
  
  CONCLUSIONS
  The RCT design supports the causal inference that iron supplementation in infancy, with or without iron supplementation in pregnancy, improved gross motor test scores at 9 months.
authors.affiliation: Department of Kinesiology, California State University, Northridge, Northridge, California; Center for Human Growth and Development, and rosa.angulobarroso@csun.edu.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Angulo-Barroso
authors.affiliation: Department of Pediatrics, and.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Center for Human Growth and Development, and Human Movement Sciences Graduate Program, Methodist University of Piracicaba, Piracicaba, SP, Brazil.
authors.forename: Denise C C
authors.initials: DC
authors.lastname: Santos
authors.affiliation: Department of Pediatrics, and.
authors.forename: Yang
authors.initials: Y
authors.lastname: Bian
authors.affiliation: Center for Human Growth and Development, and.
authors.forename: Julie
authors.initials: J
authors.lastname: Sturza
authors.affiliation: Clinical Laboratory, Peking University First Hospital, Beijing, China; and.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Center for Human Growth and Development, and.
authors.forename: Niko
authors.initials: N
authors.lastname: Kaciroti
authors.affiliation: Center for Human Growth and Development, and.
authors.forename: Blair
authors.initials: B
authors.lastname: Richards
authors.affiliation: Center for Human Growth and Development, and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan;
authors.forename: Betsy
authors.initials: B
authors.lastname: Lozoff
mesh_terms: D002657:Child Development / Q000187:drug effects*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D007501:Iron / Q000627:therapeutic use*; D008297:Male; D009048:Motor Skills / Q000187:drug effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
chemical_list: D007501:Iron