1. The Research Question
Clinical concern around iron deficiency anemia in young children centres on its association with poorer neurodevelopmental outcomes.
It is unclear whether this effect exists for iron deficiency without anemia, a much more common condition in daily primary care practice in younger children (14-50%)
What do you do with this group in practice?
BP34 Adherence to Antibiotic Prescribing for LRTI and Association With Recovery (Oral Presentation On Completed Research) Nick Francis, MD, PhD, Cardiff University; David Gillespie; Jacqueline Nuttall; Paul Little; Theo Verheij; Samuel Coenen; Jochen Cals; Kerenza Hood; Herman Goossens; Christopher Butler

2. What the Researchers Did
Cohort study of 447 children recruited at birth:
Took blood at 15 months and stored it for later assessment of iron status
At 6 years measured IQ, behaviour and psychomotor development
Measured a large number of potential covariates that influence development (perinatal factors, parental characteristics, childhood education, socio-economic status and family environment)
aged ≥18 years, consulting with an illness where an acute or worsened cough was the main or dominant symptom, or had a clinical presentation that suggested a lower respiratory tract infection that had been present for ≥28 days.

3. What the Researchers Found
Substantial proportion with ID at 15 months (25.1% ferritin ≤15µg/L) but little IDA
Early iron status was not associated with measures of intellectual performance, motor performance or behaviour at age 6.
There was no dose response or threshold effect.
There are other modifiable factors that did influence IQ behaviour and motor skills

4. What This Means for Clinical Practice
The results suggest screening, intervention and anxiety are not warranted in children with ID without anemia.
The negative influence of other potentially modifiable factors (eg lead, home environment, parental income, planning of pregnancy) supports focus on these areas.