ArticlePLOS global public health2023
Iron status in early infancy is associated with trajectories of cognitive development up to pre-school age in rural Gambia.
Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Measuring neurodevelopment in iron-deficient children in sub-Saharan Africa: A systematic review of evidence and gaps.Global epidemiology · 2026Article
- Eyes on Development: Exploring the Impact of Early Life Nutrition Exposures on Child Cognition Through Eye-Tracking Assessment.Nutrition reviews · 2026Article
- Breastfeeding status, micronutrient biomarkers, thyroid function, and Bayley-III developmental outcomes in Taiwanese toddlers.International breastfeeding journal · 2026Article
- Interconnected Developmental Trajectories of the Brain, Gut, and Sleep in Early Life: The First 1000 Days of Nutritional Opportunity.Nutrients · 2026Review
- Cross-paradigm fNIRS brain activity in 1-month-old infants across The Gambia and the United Kingdom.Neurophotonics · 2026Article
- Poverty and caregiver mental health are related to infant and toddler resting-state brain networks: insights from fNIRS.Neurophotonics · 2026Article
- Biomarkers of Brain Dysfunction in Perinatal Iron Deficiency.Nutrients · 2024Review
- The Brain Imaging for Global Health (BRIGHT) Project: Longitudinal cohort study protocol.Gates open research · 2023Article
- A Contextual Approach to Characterizing Caregiver Responsiveness in a Rural Area of The Gambia.Infancy : the official journal of the International Society on Infant StudiesArticle
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Authors and funding
11 authors at 5 institutions in 2 countries.
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Abstract
introductionIron deficiency is among the leading risk factors for poor cognitive development. However, interventions targeting iron deficiency have had mixed results on cognitive outcomes. This may be due to previous interventions focusing on the correction of iron deficiency anaemia in late infancy and early childhood, at which point long lasting neural impacts may already be established. We hypothesise that the relationship between iron status and cognitive development will be observable in the first months of life and will not be recovered by 5 years of age.
methodsUsing data from the Brain Imaging for Global Health (BRIGHT) Study in Gambia (n = 179), we conducted mixed effects modelling to assess the relationship between iron status at 5 months of age and trajectories of cognitive development from 5 months- 5 years using (i) a standardised measure of cognitive development (Mullen Scales of Early Learning) and (ii) an eye-tracking assessment of attention processing (visual disengagement time).
resultsAll infants were iron sufficient at 1 month of age. At 5 and 12 months of age 30% and 55% of infants were iron deficient respectively. In fully adjusted analyses, infants in the lowest tercile of soluble transferrin receptor (sTfR) (best iron status) achieved MSEL Cognitive Scores on average 1.9 points higher than infants in the highest sTfR tercile (p = 0.009, effect size = 0.48). There was no evidence that this group difference was recovered by 5 years of age. Infants in the lowest sTfR tercile had visual disengagement time 57ms faster than the highest tercile (p = 0.001, effect size = 0.59). However, this difference diminished by early childhood (p = 0.024).
conclusionInfants are at risk of iron deficiency in early infancy. A relationship between iron status and cognitive development is apparent from 5 months of age and remains observable at 5 years of age. One mechanism by which iron availability in early infancy impacts brain development may be through effects on early attentional processing, which is rapidly developing and has substantial nutritional requirements during this period. To support neurocognitive development, prevention of iron deficiency in pre- and early postnatal life may be more effective than correcting iron deficiency once already established.
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