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Perinatal iron deficiency and neurocognitive development
Open accessAbstract
Iron deficiency is the most common form of nutrient deficiency worldwide. It is highly prevalent due to the limited availability of high quality food in developing countries and poor dietary habits in industrialized countries. According to the World Health Organization, it affects nearly 2 billion people and up to 50% of women who are pregnant. Maternal anemia during pregnancy is especially burdensome to healthy neurodevelopment in the fetus because iron is needed for proper neurogenesis, development, and myelination. Maternal anemia also increases the risk of low birth weight, either due to premature birth or fetal growth restriction, which is associated with delayed neurocognitive development and even psychiatric illness. As rapid neurodevelopment continues after birth infants that received sufficient iron in utero, but that receive a low iron diet after 6 months of age, also show deficits in neurocognitive development, including impairments in learning and memory. Unfortunately, the neurocognitive complications of iron deficiency during critical pre- and postnatal periods of brain development are difficult to remedy, persisting into adulthood. Thus, preventing iron deficiency in the pre- and postnatal periods is critical as is devising new means to recapture cognitive function in individuals who experienced early iron deficiency. This review will discuss the prevalence of pre- and postnatal iron deficiency, the mechanism, and effects of iron deficiency on brain and cognitive development.
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“the neurocognitive damage elicited by iron deficiency during this period is irreversible and will persist into adulthood [176].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [176]
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“There is a wide consensus regarding the critical importance of appropriate iron supply during neurodevelopment from birth, and even before, up to the first years of life”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [176]
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“During this critical period, iron demand surges as new neurons, dendrites, myelin, synapses, and neurotransmitters form (37).”
Prevalence and Determinants of Anemia Among Rural Women: A Comprehensive Review
Waheed, M., Batool, S., Hussain, H. I., Liaqat, U.-E.-S., Arshad, A., Hasnain, M. M., Riaz, M. M., Fatima, M., & Talib, S. (2025) · Ecology of Food and Nutrition · doi:10.1080/03670244.2025.2580013 · Cited by 5
“Researchers are paying growing attention to how maternal ID affects brain and cognitive development in newborns (Radlowski and Johnson 2013).”
Biomarkers of Brain Dysfunction in Perinatal Iron Deficiency
Rao, R. (2024) · Nutrients · doi:10.3390/nu16071092 · Cited by 5
Iglesias‐Vázquez, L., Hernández‐Martínez, C., Voltas, N., Canals, J., Coronel, P., Gimeno, M., & Arija, V. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-05033-y · Cited by 5
Blood donation and iron deficiency
Rigas, A. S., Pedersen, O. B., Erikstrup, C., Hjalgrim, H., & Ullum, H. (2016) · ISBT Science Series · doi:10.1111/voxs.12309 · Cited by 6
Madi, N. M., & El‐Saka, M. H. (2018) · Alexandria Journal of Medicine · doi:10.1016/j.ajme.2018.05.003 · Cited by 5
“Another possible mechanism could explain the improvement of the memory impairment might be due to transferrin-mediated iron transport of LF in the brain, it could be evidenced by that iron deficiency during early life led to the subsequent impairment of both PA and active avoidance learning in rats.(24) Also, it was s…”
Kirichuk, A. A., Skalny, A. A., Додхоев, Д. С., Геннадиевна, С. М., Grabeklis, A. R., Ajsuvakova, O. P., Tinkov, A. A., Notova, S. V., Bjørklund, G., Tinkova, M. N., et al. (2019) · Journal of Trace Elements in Medicine and Biology · doi:10.1016/j.jtemb.2019.06.018 · Cited by 5
Pengaruh Zat Besi dan Seng terhadap Perkembangan Balita serta Implementasinya
Purnamasari, D. M., Lubis, L., & Gurnida, D. A. (2020) · Jurnal Sains dan Kesehatan · doi:10.25026/jsk.v2i4.194 · Cited by 5
“Penelitian pada tikus menunjukkan bahwa densitas serotonin transporter (SERT) dan norepinefrin transporter berubah akibat defisiensi zat besi [20].”
InfluentialIron Deficiency in Newborn Infants: Global Rewards for Recognizing and Treating This Silent Malady
Christensen, R. D., Bahr, T. M., & Ward, D. M. (2022) · Newborn · doi:10.5005/jp-journals-11002-0021 · Cited by 6
Lo, Y. L., & Cheng, S. (2022) · Nutritional neurosciences · doi:10.1007/978-981-19-7327-7_7 · Cited by 5
Gestational and postnatal age associations for striatal tissue iron deposition in early infancy
Cabral, L. M., Calabro, F. J., Rasmussen, J. M., Foran, W., Moore, L. A., Graham, A. M., O’Connor, T. G., Wadhwa, P. D., Entringer, S., Fair, D. A., et al. (2023) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2023.101286 · Cited by 6
Parodi, E., Ferrero, A., Perrone, B., Saracco, P., Giraudo, M. T., & Regoli, D. (2018) · Pediatrics & Neonatology · doi:10.1016/j.pedneo.2018.01.013 · Cited by 5
Antidepressant Prescription in Pregnancy
Andrade, C. (2020) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.20f13347 · Cited by 6
Anemia and Iron Supplement in Pregnancy: A Mini Review
Namazi, A. (2018) · JOJ Nursing & Health Care · doi:10.19080/jojnhc.2018.07.555711 · Cited by 5
Yun, L., Yu-mei, Z., Vallish, B., Tang, Q., & Feng, C. (2023) · Cureus · doi:10.7759/cureus.48717 · Cited by 5
Shamah‐Levy, T., Méndez‐Gómez‐Humarán, I., Pineda, E. B. G., Cuevas‐Nasú, L., & Villalpando, S. (2016) · British Journal Of Nutrition · doi:10.1017/s0007114516003019 · Cited by 4
“Fe deficiency in utero appears to have direct effects on brain maturation indicators in premature infants((11)).”
BackgroundAssociation of Prenatal Maternal Anemia with Tics and Tourette’s Syndrome in Offspring
Liu, Y., Chen, V. C., Liao, Y., & Chen, Y. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11101038 · Cited by 4
“Low maternal serum ferritin not only hinders the fetus from accumulating iron but also jeopardizes the later development of iron homeostasis in the infant [8].”
BackgroundRestless Legs and Iron Deficiency: Unraveling the Hidden Link and Unlocking Relief
Alzaabi, F. M., Tarawneh, D. J. A., Tarawneh, Y. J. A., Khan, A., Khan, M. A. M., Siddiqui, T. W., Siddiqui, R. W., Nishat, S. M. H., Alzaabi, A. A., & Siddiqui, S. W. (2025) · Cureus · doi:10.7759/cureus.82413 · Cited by 4
Impact of Iron Deficiency on the Growth and Bioelectrical Profile of Different Gut Bacteria
Quarta, E., Bourqqia‐Ramzi, M., Muñoz‐Rodriguez, D., Esteban, M. T., Murciano, A., González, Á. M., Conejero‐Meca, F. J., Lombardo‐Hernandez, J., Mansilla‐Guardiola, J., Baroni, S., et al. (2025) · MicrobiologyOpen · doi:10.1002/mbo3.70015 · Cited by 4
Bhasin, J., Fotedar, A., Chakravarty, A., Kulkarni, A., Bhalla, G., Anwar, F., & Rao, S. (2018) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_239_17 · Cited by 4
“[10,11] Iron fortification appears to be the most practical and feasible approach for anemia prevention and control although it has multifactorial etiology.[12,13] The present study provides a preliminary evidence about the benefit of IFIC in the Indian setting, and similar effects are reported by others.”
ResultCognitive and Behavioral Consequences of Brain Iron Deficiency
Aboussaleh, Y., & Bikri, S. (2022) · Nutritional neurosciences · doi:10.1007/978-981-16-6467-0_8 · Cited by 4
Iglesias‐Vázquez, L., Canals, J., Hernández‐Martínez, C., Voltas, N., & Arija, V. (2023) · Maternal and Child Nutrition · doi:10.1111/mcn.13595 · Cited by 4
“…iron deficiency (ID) has been associated with poorer cognitive development, intelligence quotient (IQ), and executive functions in children, even in mild stages without signs of anaemia (Gaillard et al., 2014; Hernández ‐ Martínez et al., 2011; McCarthy et al., 2021; Radlowski & Johnson, 2013).”
BackgroundHao, X., Guo, Y., Lu, J., Zhu, L., Yan, S., Tao, F., & Huang, K. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02411-z · Cited by 4
Popa, E., Ungureanu, M. I., Slănină, A. M., Poroch, M., Popa, A., Avram, R. I., Petroaie, A. D., Bacușcă, A. I., & Coman, A. E. (2024) · Family Medicine and Primary Care Open Access · doi:10.29011/2688-7460.100258 · Cited by 4
“Unfortunately, the neurocognitive alterations caused by iron deficiency during the critical prenatal period of brain development are difficult to reverse and persist later in life [14].”
BackgroundThe effect of a low iron diet and early life methylmercury exposure in Daphnia pulex
Hudson, S. L., Doke, D. A., & Gohlke, J. M. (2016) · Food and Chemical Toxicology · doi:10.1016/j.fct.2016.01.012 · Cited by 4
“…blood pressure, increased serum lipid profiles, and reduced myelination and subsequent neurocognitive effects in humans and rodent models (Zimmermann and Hurrell, 2007; Brabin et al., 2013; Gambling et al., 2003; Li et al., 2014; Sherman, 1979; Yu et al., 1986; Radlowski and Johnson, 2013).”
BackgroundAssessing the Impact of Serum Ferritin on Life Skills in Children with ADHD
Okuyucu, M., Kavakcı, M., Terzioğlu, M., Gökler, M. E., & Tarakçıoğlu, M. C. (2025) · Children · doi:10.3390/children12080972 · Cited by 3
Handari, S. R. T., Anies, Kartasurya, M. I., & Nugraheni, S. A. (2022) · Bali Medical Journal · doi:10.15562/bmj.v11i3.3783 · Cited by 3
Miller, E. M. (2023) · doi:10.1093/oso/9780197665718.001.0001 · Cited by 3
Campbell, R. K., Dewage, B. G., Cordero, C., Maldonado, L. E., Sotres‐Alvarez, D., Daviglus, M. L., & Argos, M. (2024) · Current Developments in Nutrition · doi:10.1016/j.cdnut.2024.104419 · Cited by 6
Rahman, S., Wallberg, L., Rahman, A. M., Ekström, E., Kippler, M. J., Hamadani, J. D., & Rahman, S. M. (2024) · Global Health Action · doi:10.1080/16549716.2024.2390269 · Cited by 3
“Deficits accrued during this period are believed to have detrimental effects on the neuro-development of the foetus [11,12].”
BackgroundSchieffer, K. M., Peters, D. G., Richter, C. K., Loc, W. S., & Pawelczyk, J. A. (2015) · Clinical and Translational Science · doi:10.1111/cts.12357 · Cited by 3
Anemia after Pediatric Congenital Heart Surgery
Jutras, C., La, K. A., Gerardis, G., Richard, R., & Pont‐Thibodeau, G. D. (2021) · Journal of Pediatric Intensive Care · doi:10.1055/s-0041-1725119 · Cited by 3
Metadata
- Authors
- Radlowski, E. C., & Johnson, R. W.
- Affiliations
- University of Illinois Urbana-Champaign (US)
- Corresponding author
- Johnson, Rodney W.
- ORCID
- Johnson, Rodney W.
- Venue
- Frontiers in Human Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2013
- Volume
- 7
- Pages
- 585-585
- ISSN
- 1662-5161 (ISSN-L)
- PMC
- PMC3779843
- OpenAlex
- W1980560945
- Cited by
- 315
- References
- 104
- Citations by year
- 2026: 16 · 2025: 27 · 2024: 17 · 2023: 32 · 2022: 34 · 2021: 25 · 2020: 23 · 2019: 23 · 2018: 29 · 2017: 33 · 2016: 20 · 2015: 21 · 2014: 13 · 2013: 1
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Human Neuroscience (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Aging (R01AG016710)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD069899)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- iron deficiency, neurocognitive development, low birth weight, fetal growth restriction, preterm birth, brain development, neurogenesis, myelination, learning and memory impairment, cognitive recovery, iron deficiency prevention
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