Behavior of elementary schoolchildren with iron deficiency anemia after iron therapy
Keywords:
behavior, iron-deficiency anemia, child behavior check list
Abstract
Background Some studies had been performed to determine theassociation between iron status and children's behavior yet it is
still controversial.
Objective To investigate whether iron therapy has an effect on
the behavior of children with iron deficiency anemia (IDA).
Method A randomized placebo-controlled clinical trial was
conducted in Labuhan Batu on November 2006-April2007. IDA
was defined as Hb < 12 g/dl, MCHC< 31%, ROW index > 220
and Mentzer index> 13. Elementary school children (6-12 years
old) with IDA were randomly assigned to the treatment group
with a daily therapy of 6 mg iron/kg/day or placebo group for three months. The subjects' behavior was evaluated with child behavior check list (CBCL) before and six months after intervention.
Results After six months, 110 subjects completed the therapy.
Scores of CBCL in iron group after intervention were internalizing
42.64 (SO 9.95), externalizing 37.13 (SO 9.04) & total score 38.24 (SO 10.20). There was significant decreased on externalizing and total problems score in the treatment group after intervention (P< 0.05). However, there was no significant difference on scores between groups.
Conclusion Iron therapy had significantly decrease CBCL score
on externalizing and total problems in the treatment group,
however there was no significant difference on scores if compared
with placebo group.
References
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In: Permono B, Sutaryo, Ugrasena IDG, Windiastuti E,
Abdulsalam M, editors. Buku ajar hematologi onkologi anak.
Jakarta: Badan penerbit IDAI, 2005; p.30-43.
2. Glacier B. Anemias of inadequate production. In: Behrman
RE, Kligman RM, Arvin AM, editors. Nelson textbook of
pediatrics. 17th ed. Philadelphia: Saunders, 2004; p. 1614-16.
3. Dallman PR. Nutritional Anemia. In: Rudolph AM, Hoffman
JIE, Rudolph CD, editors. Rudolps Pediatrics. 20th ed.
Connecticut: Appleton & Lange,l996; p.ll76-80.
4. Abdulsalam M. Diagnosis, pengobatan dan pencegahan
anemia defisiensi besi pada bayi dan anak. In: Triasih
R, editor. Anemia defisiensi besi. Yogyakarta: MEDIKA
Fakultas Kedokteran, 2005; p.55-64.
5. Sandoval C, Jayabose S, Eden AN. Trends in diagnosis and
management of iron deficiency during infancy and early
childhood. Clin Adv Hematol Oneal. 2004;18: 1423-38.
6. McGregor SG, Ani C. A review of studies on the effect of
iron deficiency on cognitive development in children. J Nutr.
2001; 131 :649S-68S.
7. Saloojee H, Pettifor JM. Iron deficiency and impaired child
development, the relation may be causal, but it may not be
a priority for intervention. BMJ. 2001 ;323: 13 77-8.
8. Lozoff B, Jimenez E, Hagen J, Mallen E, Wolf A W. Poorer
behavioral and developmental outcome more than 10 years
after treatment for iron deficiency in infancy. Pediatrics.
2000; 105:e51-61.
9. Yager JY, Hartfield OS. Review neurologic manifestations of
iron deficiency in childhood. Pediatr Neural. 2002;27:85-92.
10. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P,
Szilagyi PG. Iron deficiency and cognitive achievement
among school-aged children and adolescents in the United
States. Pediatrics. 2001; 107: 1381-6.
11. Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I,
Purwanto SH. Perkiraan besar sampel. In: Sastroasmoro S,
Ismael S, editors. Dasar-dasar metodologi penelitian klinis.
Jakarta: Sagung Seto, 2008; p. 314.
12. Andraca I, Castillo M, Walter T. Psychomotor development
and behavior in iron-deficient anemic infants. Nutr Rev.
1997;55:125-32.
13. Beard JL.Iron biology in immune function, muscle metabolism
and neuronal functioning. J Nutr. 2001;131:568S-580S.
14. Beard J. Iron deficiency alters brain development and
functioning. J Nutr. 2003; 133: 1468S-72S.
15. McCann JC, Ames BN. An overview of evidence for a causal
relation between iron deficiency during development and
deficits in cognitive or behavioral function. Am J Clin Nutr.
2007 ;85:931-45.
16. GeorgieffMK. Nutrition and the developing brain: nutrient
priorities and measurement. Am J Clin N utr. 2007 ;85:614S-
24S.
17. Lozoff B, Corapci F, Burden MJ, Kaciroti N, Angulo-Barroso
R, Sazawal S, et al. Preschool-aged children with iron
deficiency anemia show altered affect and behavior. J Nutr.
2007;137:683-9.
18. Bruner AB, Joffe A, Duggan K, Casella JF, Brandt J.
Randomised study of cognitive effects of iron suplementation
in non-anaemic iron-deficient adolescent girls. Lancet.
1996;348:992-6.
19. Achenbach TM. Manual for the child behavior checklist/4-
18 and 1991 profile. Burlington VT: University of Vermont
Department of Psychiatry, 1991; p. 22 7.
20. Glascoe FP. Developmental screening. In: Parker S,
Zuckerman B, editors. Behavioral and developmental
pediatrics, a handbook for primary care. Boston: Little Brown
Company, 1995; p. 25-9.
21. Rudan V, Begovac I, Szirovicza L, Filipovic 0, Skocic M.
The child behavior checklist, teacher report form and
youth self report problem scales in a normative sample of
croatian children and adolescents aged 7- 18. Coli Antropol.
2005;29: 17-26.
22. Achenbach TM, Ruffle TM. The child behavior checklist
and related forms for assessing behavioral/emotional problems
and competencies. Pediatr Rev. 2000;21:265-71.
Published
2009-10-31
How to Cite
1.
Saragih R, Zulaicha T, Sofyani S, Lubis B, Lubis I. Behavior of elementary schoolchildren with iron deficiency anemia after iron therapy. PI [Internet]. 31Oct.2009 [cited 13Nov.2024];49(5):276-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/583
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Received 2016-09-11
Accepted 2016-09-11
Published 2009-10-31
Accepted 2016-09-11
Published 2009-10-31
