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

Publication date: Jun 10, 2025

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.

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Concepts Keywords
Autism Anemia, Iron-Deficiency
Bulgaria anthropometry
Nutritional autism
Therapy Autism Spectrum Disorder
Bulgaria
Cerebral Palsy
cerebral palsy
Child
Child Development
Child, Preschool
Cross-Sectional Studies
Female
Ferritins
Ferritins
hemoglobin
Hemoglobins
Hemoglobins
Humans
Iron
Iron
Iron Deficiencies
iron deficiency
Male
nutritional deficiencies
Nutritional Status
nutritional status
Prevalence
serum ferritin

Semantics

Type Source Name
disease MESH Iron Deficiency
disease MESH Cerebral Palsy
disease MESH Autism
drug DRUGBANK Iron
disease MESH nutritional status
disease MESH autism spectrum disorder
drug DRUGBANK Human Serum Albumin
drug DRUGBANK Coenzyme M
disease MESH nutritional deficiencies
pathway REACTOME Metabolism
drug DRUGBANK Dopamine
drug DRUGBANK Norepinephrine
drug DRUGBANK Serotonin
disease MESH Anemia
disease MESH psychiatric disorders
disease MESH neurodevelopmental disorders
disease MESH mood disorders
disease MESH attention deficit hyperactivity disorder
disease MESH stunted growth
disease MESH abnormalities
disease MESH syndromes
disease MESH contractures
drug DRUGBANK Sodium lauryl sulfate
drug DRUGBANK Methionine
disease MESH Marital Status
disease MESH Anemia Iron-Deficiency

Original Article

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