Microcytosis is associated with low cognitive outcomes in healthy 2-year-olds in a high-resource setting

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dc.contributor.author McCarthy, Elaine K.
dc.contributor.author Kiely, Mairead E.
dc.contributor.author Hannon, Geraldine
dc.contributor.author Ahearne, Caroline E.
dc.contributor.author Kenny, Louise C.
dc.contributor.author Hourihane, Jonathan O'B.
dc.contributor.author Irvine, Alan D.
dc.contributor.author Murray, Deirdre M.
dc.date.accessioned 2017-10-05T09:15:10Z
dc.date.available 2017-10-05T09:15:10Z
dc.date.issued 2017-09-13
dc.identifier.citation McCarthy, E. K., Kiely, M. E., Hannon, G., Ahearne, C., Kenny, L. C., Hourihane, J. O. B., Irvine, A. D. and Murray, D. M. (2017) 'Microcytosis is associated with low cognitive outcomes in healthy 2-year-olds in a high-resource setting', British Journal of Nutrition, 118(5), pp. 360-367. doi: 10.1017/S0007114517001945 en
dc.identifier.volume 118 en
dc.identifier.issued 5 en
dc.identifier.startpage 360 en
dc.identifier.endpage 367 en
dc.identifier.issn 0007-1145
dc.identifier.uri http://hdl.handle.net/10468/4833
dc.identifier.doi 10.1017/S0007114517001945
dc.description.abstract Fe deficiency in early childhood is associated with long-term consequences for cognitive, motor and behavioural development; however explorations in healthy children from low risk, high-resource settings have been limited. We aimed to explore associations between Fe status and neurodevelopmental outcomes in low risk, healthy 2-year-olds. This study was a secondary analysis of a nested case–control subgroup from the prospective, maternal-infant Cork Babies after Screening for Pregnancy Endpoints: Evaluating the Longitudinal Impact using Neurological and Nutritional Endpoints (BASELINE) Birth Cohort Study. At 2 years, serum ferritin, Hb and mean corpuscular volume (MCV) were measured and neurodevelopment was assessed using the Bayley Scales of Infant and Toddler Development (n 87). Five children had Fe deficiency (ferritin <12 µg/l) and no child had Fe deficiency anaemia (Hb<110 g/l+ferritin<12 µg/l). Children with microcytosis (MCV<74 fl, n 13) had significantly lower mean cognitive composite scores (88·5 (sd 13·3) v. 97·0 (sd 7·8), P=0·04, Cohen’s d effect size=0·8) than those without microcytosis. The ferritin concentration which best predicted microcytosis was calculated as 18·4 µg/l (AUC=0·87 (95% CI 0·75, 0·98), P<0·0001, sensitivity 92 %, specificity 75 %). Using 18·5 µg/l as a threshold, children with concentrations <18·5 µg/l had significantly lower mean cognitive composite scores (92·3 (sd 10·5) v. 97·8 (sd 8·1), P=0·012, Cohen’s d effect size=0·6) compared with those with ferritin ≥18·5 µg/l. All associations were robust after adjustment for potential confounding factors. Despite a low prevalence of Fe deficiency using current diagnostic criteria in this healthy cohort, microcytosis was associated with lower cognitive outcomes at 2 years. This exploratory study emphasises the need for re-evaluation of the diagnostic criteria for Fe deficiency in young children, with further research in adequately powered studies warranted. en
dc.description.sponsorship Danone (Danone Nutricia Early Life Nutrition); Health Research Board of Ireland (SCOPE Ireland Study (CSA 02/2007)) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Cambridge University Press en
dc.rights © The Authors 2017. Published by Cambridge University Press on behalf of The Nutrition Society. en
dc.subject Bayley Scales of Infant and Toddler Development en
dc.subject Microcytosis en
dc.subject Serum ferritin en
dc.subject Neurodevelopment en
dc.subject Cognition en
dc.title Microcytosis is associated with low cognitive outcomes in healthy 2-year-olds in a high-resource setting en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Deirdre Murray, Paediatrics & Child Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: d.murray@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2018-09-13
dc.date.updated 2017-10-05T08:57:51Z
dc.description.version Published Version en
dc.internal.rssid 413703656
dc.contributor.funder Health Research Board en
dc.contributor.funder Science Foundation Ireland en
dc.contributor.funder Danone en
dc.contributor.funder National Children’s Research Centre, Ireland
dc.contributor.funder Food Standards Agency
dc.description.status Peer reviewed en
dc.identifier.journaltitle British Journal of Nutrition en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress d.murray@ucc.ie en
dc.internal.IRISemailaddress elaine.mccarthy@ucc.ie en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/ en

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