Iron deficiency anemia in 1-year-old children of disadvantaged families in Montreal.

OBJECTIVES To determine the prevalence of iron deficiency anemia among 1-year-old infants of disadvantaged families in Montreal as well as certain predictors of this condition. DESIGN Cohort study. SETTING Five poorest health districts in Montreal. PARTICIPANTS Infants 10 to 14 months of age were identified from registration lists of births from May 1988 to August 1989. Those whose mother had less than 11 years of schooling and a family income below the government-defined low-income cutoff point were eligible. INTERVENTION During a home visit capillary blood samples were obtained from the child, and the mother answered a questionnaire about infant-feeding practices. Infants with a serum ferritin level of 10 micrograms/L or less and either a hemoglobin level of 115 g/L or less or a mean corpuscular volume of 72 fL or less were considered as having iron deficiency anemia. RESULTS Of the 299 mothers who were eligible and could be located 220 (74%) agreed to participate; 218 blood samples were available. Iron deficiency anemia was found in 25% of the infants (95% confidence interval [CI] 19% to 31%). The mean hemoglobin level was 115 (standard deviation 11) g/L. The serum ferritin level, assessed routinely in the last 62 infants, was 10 micrograms/L or less in 37% of the infants. The factors that were found to be predictors of iron deficiency anemia included the use of whole cow's milk before 6 months of age (odds ratio [OR] 3.56 [95% CI 1.07 to 11.26]) and the use of iron-fortified infant cereal for less than 6 months (OR 3.15 [95% CI 1.25 to 7.96]). A low birth weight and the use of iron-fortified formula for less than 6 months were associated with iron deficiency anemia. CONCLUSIONS Despite a decrease in the prevalence of iron deficiency anemia among children of disadvantaged families in the United States socioeconomically disadvantaged infants in Montreal are at risk. Preventive measures must be taken to ensure adequate iron status in the first year of life.

[1]  E. Pollitt,et al.  Effects of iron deficiency on attention and learning processes in preschool children: Bandung, Indonesia. , 1989, The American journal of clinical nutrition.

[2]  S. Seshadri,et al.  Impact of iron supplementation on cognitive functions in preschool and school-aged children: the Indian experience. , 1989, The American journal of clinical nutrition.

[3]  T Walter,et al.  Iron deficiency anemia: adverse effects on infant psychomotor development. , 1989, Pediatrics.

[4]  CDC criteria for anemia in children and childbearing-aged women. , 1989, MMWR. Morbidity and mortality weekly report.

[5]  D. Horvitz,et al.  Historical study of pregnancy outcomes. , 1988 .

[6]  F. Oski,et al.  Consequences of starting whole cow milk at 6 months of age. , 1987, The Journal of pediatrics.

[7]  N. Binkin,et al.  Declining prevalence of anemia among low-income children in the United States. , 1987, JAMA.

[8]  M. Olivares,et al.  Effect of an iron fortified milk on morbidity in infancy. A field trial , 1987 .

[9]  G. Brittenham,et al.  Behavioral alterations in iron deficiency. , 1987, Hematology/oncology clinics of North America.

[10]  P. Dallman.  Iron deficiency and the immune response. , 1987, The American journal of clinical nutrition.

[11]  D. McClish,et al.  Iron deficiency anemia and iron therapy effects on infant developmental test performance. , 1987, Pediatrics.

[12]  A. Stekel,et al.  Effect of iron therapy on phagocytosis and bactericidal activity in neutrophils of iron-deficient infants. , 1986, The American journal of clinical nutrition.

[13]  B. Wharton,et al.  Treatment with iron increases weight gain and psychomotor development. , 1986, Archives of disease in childhood.

[14]  R. Wasserman,et al.  Evaluation of the capillary microhematocrit as a screening test for anemia in pediatric office practice. , 1986, Pediatrics.

[15]  P. Dallman.  Iron Deficiency in the Weanling: a Nutritional Problem on the Way to Resolution , 1986, Acta paediatrica Scandinavica. Supplement.

[16]  J. Cook,et al.  The liabilities of iron deficiency. , 1986, Blood.

[17]  D. Evans.  Cerebral function in iron deficiency: a review. , 1985, Child: care, health and development.

[18]  F. Oski.  Iron deficiency--facts and fallacies. , 1985, Pediatric clinics of North America.

[19]  E. Pollitt,et al.  COGNITIVE EFFECTS OF IRON-DEFICIENCY ANAEMIA , 1985, The Lancet.

[20]  R. Yip,et al.  Developmental changes in serum ferritin and erythrocyte protoporphyrin in normal (nonanemic) children. , 1983, The American journal of clinical nutrition.

[21]  E. Vichinsky,et al.  Iron deficiency in health and disease. , 1983, Advances in pediatrics.

[22]  P. Dallman,et al.  Diagnosis of iron deficiency: the limitations of laboratory tests in predicting response to iron treatment in 1-year-old infants. , 1981, The Journal of pediatrics.

[23]  P. Dallman,et al.  Screening for iron deficiency anemia in one-year-old infants: hemoglobin alone or hemoglobin and mean corpuscular volume as predictors of response to iron treatment. , 1981, The Journal of pediatrics.

[24]  R. Mittleman.  Need for iron supplementation in infants on prolonged breast feeding. , 1979, The Journal of pediatrics.

[25]  D. Kallen,et al.  Nutrition and social correlates in iron deficiency anemia. , 1978, The American journal of clinical nutrition.

[26]  D. Kallen,et al.  Iron deficiency with and without anemia in infants and children. , 1974, American journal of diseases of children.

[27]  P. Dallman,et al.  Ferritin in serum: diagnosis of iron deficiency and iron overload in infants and children. , 1974, Blood.

[28]  A. Novack,et al.  Nutritional anemia in an inner-city community. Relationship to age and ethnic group. , 1972, JAMA.

[29]  M. B. Andelman,et al.  Utilization of dietary iron by term infants. A study of 1,048 infants from a low socioeconomic population. , 1966, American journal of diseases of children.