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Nutritional Epidemiology

Mother-Infant Interactions and Infant Development Are Altered by Maternal Iron Deficiency Anemia¹

Eva M. Perez, Michael K. Hendricks, John L. Beard^*,2, Laura E. Murray-Kolb^*, Astrid Berg, Mark Tomlinson, James Irlam, Washiefa Isaacs, T. Njengele, Alan Sive and Lynne Vernon-Feagans

School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa; ^* Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA; and School of Education, University of North Carolina, Chapel Hill, NC

²To whom correspondence should be addressed. E-mail: jbeard{at}psu.edu.

The aim of this study was to determine whether iron deficiency anemia (IDA) in young South African mothers alters mother-infant interactions and the infant’s development. The study was a prospective, randomized, controlled intervention trial with 3 groups of mothers: nonanemic controls and anemic mothers administered either placebo (25 mg ascorbic acid and 10 µg folate) or daily iron treatment (125 mg FeSO₄ plus ascorbate and folate). Mothers of full-term, normal birth weight infants (n = 81) were followed from 10 wk to 9 mo postpartum. Maternal iron status, socioeconomic level, mother-infant interaction [Parent/Caregiver Involvement Scale (PCIS scale)], and infant development (Griffiths scale) were assessed. At baseline, anemic mothers tended (P < 0.10) to be less responsive to, and more controlling of, their infants. Infants of anemic mothers were developmentally delayed at 10 wk in hand-eye movement and overall quotient. Despite normalization of maternal iron status with supplementation in some mothers, the developmental delays were not diminished at 9 mo. At 9 mo, anemic mothers were significantly more "negative" towards their babies, engaged less in goal setting, and were less "responsive" than control mothers. In contrast, the behavior of anemic mothers given iron treatment toward their children was similar to that of the control mothers on all 11 scales of the PCIS. In conclusion, IDA altered mother-child interactions at both 10 wk and 9 mo postpartum. Additionally, infants whose mothers were anemic in the early postpartum scored worse on developmental tests at 10 wk and 9 mo of age.

KEY WORDS: • iron • postpartum • infant • cognition • behavior • development

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