Judy Skatssoon
ABC Science Online
Tuesday, 18 October 2005
Abnormal behaviour was higher among children whose mothers took iron
supplements when pregnant.
Women who take iron tablets when pregnant get short-term benefits but
contrary to some research their children aren't smarter, a new study
shows.
In fact the study, presented at a haematology meeting in Sydney today,
links iron supplementation to "abnormal" behaviour in children four
years down the track.
Researcher Dr Maria Makrides, a nutritionist from South Australia's
Child Health Research Institute, says this is based on a small number
of parent-reported problems and needs to be replicated when the
children start school.
Makrides says 431 pregnant women took part in the Adelaide study. Half
took a daily 20 milligram iron tablet, the rest a placebo.
At the end of their pregnancies, only 3% of the women in the iron
group had iron deficiency anaemia compared with 11% who didn't get
extra iron. Women taking supplements also had better iron stores six
months after delivery.
But that's where the benefits end, says Makrides.
She says there's a lack of long-term data on what happens to children
after iron supplementation in pregnancy, although some studies in
developing countries suggest it improves child development.
"What we found was that there was absolutely no difference in the IQ
of the children of the mothers who got iron or placebo during
pregnancy," she says.
A puzzling result
But when parents were surveyed about the behaviour of their children,
the women who received iron supplements reported more "abnormal
behaviour" than those without supplements.
The abnormal behaviour related to peer conduct, socialisation and
hyperactivity.
"When we looked at the percentage of children above the so-called
abnormal behaviour cut-off there were a few more in the iron group
and ... that was a quite unexpected finding," she says.
In short, the children were "more difficult to handle".
But Makrides says this has to be interpreted with caution because only
a small number (10%) of all the children had abnormal behaviour and
this was based on the parent's assessment.
"We're planning to do a longer term study to find out what happens to
these kids when they start school," she says.
To supplement or not
Makrides says the study raises questions about whether all pregnant
women should be advised to take iron supplements in the same way
they're told to take folate.
At present, Australia takes a "screen and treat" approach to iron
deficiency, where supplements are only recommended if iron levels are
low, unlike countries such as the US and France, which take a blanket
approach to supplementation.
Makrides says although the tablets do a "fabulous job of preventing
anaemia" in the women there were no other associated benefits,
probably because nutritional standards in Australia are already high.
"So ... perhaps we shouldn't need to go out and have a broad
supplementation program," she says.
"Starting from a good [nutritional] baseline ... do you get to a point
where more is not better and more might be doing some harm?"
Dr Peter Clifton, research director of nutrition at CSIRO, says not
all women need extra iron during pregnancy, although around 10-15%
women of reproductive age are at the lower end of the iron scale.
"If the woman is vegetarian she's probably running short but if she's
on a mixed diet ... she's probably likely to be getting enough iron,"
he says.
New guidelines on the way
The National Health and Medical Research Council (NHMRC) is reviewing
recommended dietary intake guidelines, including iron, across
Australia and New Zealand.
Current guidelines recommend 10-20 milligrams of iron daily for
pregnant women and say "small supplements may be necessary".
An NHMRC spokeswoman says new guidelines are set to be published by
the end of the year.
The first stage of Makrides' research was published in the American
Journal of Clinical Nutrition and the four year follow-up has been
submitted for publication.
http://www.abc.net.au/science/news/health/HealthRepublish_1484197.htm
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