Iron Deficiency Prevalence in Bulgarian Children with Cerebral Palsy and Autism: A Call for Nutritional Interventions to Support Development

Abstract

Background/Objectives: Iron plays an important role in cognitive, behavioral, and motor development. This study aims to assess the iron nutritional status of Bulgarian children with cerebral palsy (CP) and autism spectrum disorder (ASD), focusing on iron deficiency (ID) and its impact on children's development. We hypothesized that children with CP and ASD suffer from iron deficiency. Methods: The cross-sectional study includes 95 children from northeastern Bulgaria. Data were collected in two periods (2017-2018 and 2023-2024). Demographic questionnaires, food frequency questionnaires, and laboratory tests for hemoglobin, serum iron, serum ferritin, serum albumin, and CRP were conducted. Anthropometric measurements were evaluated. The Gross Motor Function Classification System scale was used to assess motor function in children with CP. Statistical analysis was performed using Jamovi software, ver. 2.6.44, with a significance level of p < 0.05. Results: Of the 95 children, 62.1% had CP and 37.9% had ASD. Most children had normal hemoglobin and serum iron levels, but 62.7% of those with CP and 36.8% of those with ASD had low serum ferritin levels, indicating latent ID. A higher proportion of children with CP than those with ASD consumed meat daily, while fish was more commonly consumed by children with ASD. Anthropometric data showed delayed growth and lower height-for-age scores in children with CP. Conclusions: The study identifies latent ID in children with CP and ASD. An evaluation of dietary habits highlights the need for interventions to improve nutritional status and development. The observed deficiencies emphasize the need for regular monitoring and targeted dietary programs for children in these groups.

Keywords: anthropometry; autism; cerebral palsy; hemoglobin; iron deficiency; nutritional deficiencies; nutritional status; serum ferritin.