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Title: | Effects of daily iron supplementation in primary-school-aged children: Systematic review and meta-analysis of randomized controlled trials. | Authors: | Biggs B.-A.;Pasricha S.-R.;Low M. ;Farrell A. | Institution: | (Low) Department of Clinical Haematology, Alfred Hospital, Prahran, Australia (Farrell, Pasricha) Thalassaemia Service, Southern Health, Clayton, United States (Biggs, Pasricha) Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Carlton, Australia (Pasricha) Nossal Institute for Global Health, Faculty of Medicine, University of Melbourne, Carlton, VIC, Australia | Issue Date: | 24-Dec-2013 | Copyright year: | 2013 | Publisher: | Canadian Medical Association (1867 Alta Vista Drive, Ottawa KIG5W8, Canada) | Place of publication: | Canada | Publication information: | CMAJ. 185 (17) (pp E791-E802), 2013. Date of Publication: 19 Nov 2013. | Abstract: | Background: Anemia is an important public health and clinical problem. Observational studies have linked iron deficiency and anemia in children with many poor outcomes, including impaired cognitive development; however, iron supplementation, a widely used prevent - ive and therapeutic strategy, is associated with adverse effects. Primary-school-aged children are at a critical stage in intellectual development, and optimization of their cognitive performance could have long-lasting individual and population benefits. In this study, we summarize the evidence for the benefits and safety of daily iron supplementation in primary-school-aged children. Method(s): We searched electronic databases (including MEDLINE and Embase) and other sources (July 2013) for randomized and quasirandomized controlled trials involving daily iron supplementation in children aged 5-12 years. We combined the data using random effects meta-analysis. Result(s): We identified 16 501 studies; of these, we evaluated 76 full-text papers and included 32 studies including 7089 children. Of the included studies, 31 were conducted in low- or middleincome settings. Iron supplementation improved global cognitive scores (standardized mean difference 0.50, 95% confidence interval [CI] 0.11 to 0. 90, p = 0.01), intelligence quotient among anemic children (mean difference 4.55, 95% CI 0.16 to 8.94, p = 0.04) and measures of attention and concentration. Iron supplementation also improved age-adjusted height among all children and age-adjusted weight among anemic children. Iron supplementation reduced the risk of anemia by 50% and the risk of iron deficiency by 79%. Adherence in the trial settings was generally high. Safety data were limited. Interpretation(s): Our analysis suggests that iron supplementation safely improves hematologic and nonhematologic outcomes among primary-school-aged children in low- or middleincome settings and is well-tolerated. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1503/cmaj.130628 | PubMed URL: | 24130243 [http://www.ncbi.nlm.nih.gov/pubmed/?term=24130243] | ISSN: | 0820-3946 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/27612 | Type: | Article | Subjects: | *iron therapy lowest income group major clinical study malaria/dt [Drug Therapy] malaria/si [Side Effect] mental concentration mental performance meta analysis patient compliance randomized controlled trial risk reduction scoring system social status systematic review treatment response vomiting/si [Side Effect] albendazole/cb [Drug Combination] anthelmintic agent/cb [Drug Combination] anthelmintic agent/dt [Drug Therapy] ferrous fumarate/ct [Clinical Trial] ferrous fumarate/cb [Drug Combination] ferrous fumarate/dt [Drug Therapy] ferrous gluconate/ct [Clinical Trial] ferrous gluconate/cb [Drug Combination] ferrous gluconate/dt [Drug Therapy] ferrous sulfate/ct [Clinical Trial] ferrous sulfate/cb [Drug Combination] ferrous sulfate/dt [Drug Therapy] folic acid/cb [Drug Combination] *iron/ae [Adverse Drug Reaction] *iron/ct [Clinical Trial] *iron/cb [Drug Combination] *iron/dt [Drug Therapy] *iron/po [Oral Drug Administration] iron dextran/ct [Clinical Trial] iron dextran/cb [Drug Combination] iron dextran/dt [Drug Therapy] iron polymaltose/ct [Clinical Trial] iron polymaltose/dt [Drug Therapy] mebendazole/cb [Drug Combination] mebendazole/dt [Drug Therapy] multivitamin/cb [Drug Combination] placebo zinc/cb [Drug Combination] article attention body weight child cognitive defect constipation/si [Side Effect] controlled study diarrhea/si [Side Effect] drug safety evidence based medicine gastrointestinal symptom/si [Side Effect] hookworm infection/dt [Drug Therapy] human intelligence quotient iron deficiency anemia/dt [Drug Therapy] gastrointestinal symptom / side effect hookworm infection / drug therapy human intelligence quotient iron deficiency anemia / drug therapy *iron therapy lowest income group major clinical study malaria / drug therapy / side effect mental concentration mental performance meta analysis patient compliance randomized controlled trial risk reduction scoring system social status attention treatment response vomiting / side effect article systematic review body weight child cognitive defect constipation / side effect controlled study diarrhea / side effect drug safety evidence based medicine |
Type of Clinical Study or Trial: | Systematic review and/or meta-analysis |
Appears in Collections: | Articles |
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