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Approaches for Reducing the Risk of Early-Life Iron Deficiency-Induced Brain Dysfunction in Children

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Division of Global Pediatrics, Department of Pediatrics, and Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN 55455, USA
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Division of Neonatology, Department of Pediatrics, Institute of Child Development, and Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN 55455, USA
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Center for Neurobehavioral Development, University of Minnesota, 717 Delaware Street SE, Suite 333, Minneapolis, MN 55414, USA
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(2), 227; https://doi.org/10.3390/nu10020227
Received: 19 January 2018 / Revised: 12 February 2018 / Accepted: 14 February 2018 / Published: 17 February 2018
(This article belongs to the Special Issue Fe Deficiency, Dietary Bioavailbility and Absorption)
Iron deficiency is the most common micronutrient deficiency in the world. Women of reproductive age and young children are particularly vulnerable. Iron deficiency in late prenatal and early postnatal periods can lead to long-term neurobehavioral deficits, despite iron treatment. This may occur because screening and treatment of iron deficiency in children is currently focused on detection of anemia and not neurodevelopment. Anemia is the end-stage state of iron deficiency. The brain becomes iron deficient before the onset of anemia due to prioritization of the available iron to the red blood cells (RBCs) over other organs. Brain iron deficiency, independent of anemia, is responsible for the adverse neurological effects. Early diagnosis and treatment of impending brain dysfunction in the pre-anemic stage is necessary to prevent neurological deficits. The currently available hematological indices are not sensitive biomarkers of brain iron deficiency and dysfunction. Studies in non-human primate models suggest that serum proteomic and metabolomic analyses may be superior for this purpose. Maternal iron supplementation, delayed clamping or milking of the umbilical cord, and early iron supplementation improve the iron status of at-risk infants. Whether these strategies prevent iron deficiency-induced brain dysfunction has yet to be determined. The potential for oxidant stress, altered gastrointestinal microbiome and other adverse effects associated with iron supplementation cautions against indiscriminate iron supplementation of children in malaria-endemic regions and iron-sufficient populations. View Full-Text
Keywords: iron; iron deficiency; iron supplementation; infants; children; neurodevelopment; brain dysfunction iron; iron deficiency; iron supplementation; infants; children; neurodevelopment; brain dysfunction
MDPI and ACS Style

Cusick, S.E.; Georgieff, M.K.; Rao, R. Approaches for Reducing the Risk of Early-Life Iron Deficiency-Induced Brain Dysfunction in Children. Nutrients 2018, 10, 227.

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