Iron status and neuropsychological consequences in women of reproductive age: what do we know and where are we headed?

Iron deficiency disproportionately affects infants, children, and women of reproductive age. It is more prevalent in developing countries but continues to be a problem in developed countries. Included among the consequences of iron deficiency are changes in cognitive performance, emotions, and behavior. Although the behavioral and developmental sequelae of iron deficiency in young children have received much interest, data on the consequences of iron deficiency in women of reproductive age are just beginning to emerge. Interest in this area increased as a result of the findings that brain iron is much more fluid than previously thought and iron-deficient animals experience nondevelopment-dependent brain alterations. These findings, coupled with the symptoms often reported by iron-deficient women (lethargy, inability to concentrate, difficulty with memory, etc.), have led researchers to begin to explore the relation between iron and neuropsychological outcomes in this population. This paper reviews findings from studies that have examined the brain functional consequences of iron deficiency in women of reproductive age. Additional consideration is given to the fact that detriments to cognition and behavior in a woman of reproductive age may have negative implications beyond the woman's health; specifically, they may negatively influence her children. Therefore, the roles that cognitive and behavioral changes in these women have on their children's development is also reviewed. The paper concludes with a discussion on ways to use technological advances (especially in neuroimaging techniques) to help us elucidate the role of iron in the brains of women of reproductive age.