Iron deficiency and infant motor development

Tal Shafir, Rosa Angulo-Barroso, Yuezhou Jing, Mary Lu Angelilli, Sandra W. Jacobson, Betsy Lozoff

Research output: Contribution to journalArticlepeer-review


Background: Iron deficiency (ID) during early development impairs myelination and basal ganglia function in animal models. Aims: To examine the effects of iron deficiency anemia (IDA) and iron deficiency (ID) without anemia on infant motor skills that are likely related to myelination and basal ganglia function. Study design: Observational study. Subjects: Full-term inner-city African-American 9- to 10-month-old infants who were free of acute or chronic health problems with iron status indicators ranging from IDA to iron sufficiency (n = 106). Criteria for final iron status classification were met by 77 of these infants: 28 IDA, 28 non-anemic iron-deficient (NA ID), and 21 iron-sufficient (IS). Outcome measures: Gross motor developmental milestones, Peabody Developmental Motor Scale, Infant Neurological International Battery (INFANIB), motor quality factor of the Bayley Behavioral Rating Scale, and a sequential/bi-manual coordination toy retrieval task. General linear model analyses tested for linear effects of iron status group and thresholds for effects. Results: There were linear effects of iron status on developmental milestones, Peabody gross motor (suggestive trend), INFANIB standing item, motor quality, and toy retrieval. The threshold for effects was ID with or without anemia for developmental milestones, INFANIB standing item, and motor quality and IDA for toy retrieval. Conclusions: Using a comprehensive and sensitive assessment of motor development, this study found poorer motor function in ID infants with and without anemia. Poorer motor function among non-anemic ID infants is particularly concerning, since ID without anemia is not detected by common screening procedures and is more widespread than IDA.

Original languageEnglish
Pages (from-to)479-485
Number of pages7
JournalEarly Human Development
Issue number7
StatePublished - Jul 2008
Externally publishedYes

Bibliographical note

Funding Information:
This research was funded by grants from the National Institutes of Health (P01 HD39386, Brain and Behavior in Early Iron Deficiency, Betsy Lozoff, Principal Investigator) and the Joseph Young, Sr., Fund, in Michigan (Sandra W. Jacobson, Principal Investigator). We are grateful to the study families; to Sheila Gahagan for training in administration of the INFANIB; to Joseph L. Jacobson for consultation regarding research design and data analysis; to Rinat Armony-Sivan, Renee Sun, Margo Laskowski, Jigna Zatakia, Brenda Tuttle, and Douglas Fuller for their contributions in recruitment, infant assessment, and data management and analysis; to William Neeley (Director, Detroit Medical Center University Laboratories), John Beard (Pennsylvania State University) and the laboratory staff at both institutions for performing the hematologic and biochemical assays; and to student coders for their help in video coding. The entire group of investigators participating in the Brain and Behavior in Early Iron Deficiency Program Project contributed to our thinking and understanding of effects of ID on early motor development.


  • Infant
  • Iron deficiency
  • Motor development

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health


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