In this issue of the Archives, Lozoff et al1 report the findings of a long-term follow-up of children at 10 years of age who were participants in a double-masked, randomized controlled trial conducted from 1991 through 1994 in Santiago, Chile, testing iron-fortified (12.7 mg/L) vs low-iron (2.3 mg/L) infant formula use from 6 to 12 months of age.2 All infants enrolled in the original trial were screened to have no iron deficiency anemia at the outset. Among 57% of the original sample of children who were reached, an intent-to-treat analysis showed that the mean scores on tests of spatial memory and visual-motor integration at 10 years of age were lower in the iron-fortified group compared with the control.1 The mean effect sizes for both these outcomes were small (−0.21), whereas effect sizes for other measures, such as overall IQ, arithmetic, visual perception, and motor coordination, showing a similar negative trend were even smaller, ranging from −0.08 to −0.16, and not significant. Stratified analyses revealed large negative effect sizes (−0.85 to −1.36) of the iron formula among children who had high hemoglobin (Hb) levels (Hb level >12.7-13.0 g/dL, 5.0%-5.5% of the sample) at the start of the trial, whereas those with low Hb level (<10.4-10.7 g/dL, 9%-24% of the sample) benefitted somewhat with the intervention. For a large proportion of children with Hb concentrations in the middle of the distribution (10.8-12.7 g/dL, 70%-90% of the sample) the iron intervention did not have any impact on the measured outcomes. (To convert Hb to grams per liter, multiply by 10.0.)
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Thank you for submitting a comment on this article. It will be reviewed by JAMA Pediatrics editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Register Now
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.