TABLE 1.

The consequences of iron prioritization in the fetus and infant¹

Evidence of prioritization of iron to RBCs over brain in preclinical models and in humans:

Polycythemic newborn infants of diabetic mothers have 40% loss of brain iron and complete loss of hepatic iron stores (31)

Brain metabolism is compromised before anemia in iron-deficient monkeys (32)

Nonanemic (polycythemic) fetal sheep show interorgan prioritization (33)

Phlebotomized anemic lambs show preferential loss of brain iron over RBCs (34)

Potential neurologic consequences:

Nonanemic ID in toddlers reduces motor and affective domain function (35)

Polycythemic infants of diabetic mothers with SF concentrations <40 μg/L have abnormal recognition memory processing (36)

A nonanemic genetic mouse model of hippocampus-specific ID showed compromised learning and memory (37)

¹ID, iron deficiency; RBC, red blood cell; SF, serum ferritin.