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Haemoglobin and ferritin concentrations in children aged 12 and 18 months. ALSPAC Children in Focus Study Team
A Sherriff1, A Emond, N Hawkins
1Unit of Paediatric and Perinatal Epidemiology, University of Bristol, UK.
Insights
This study defined normal haemoglobin and ferritin ranges in British children, finding iron stores deplete during infancy. Associated factors included sex, maternal education, and weight, with correlations observed over time.
Area of Science:
- Pediatric Nutrition
- Hematology
- Public Health
Background:
- Infancy involves rapid growth, potentially depleting iron stores.
- Understanding normal haemoglobin and ferritin levels is crucial for child health.
- Previous research has not fully characterized these parameters in British children at key developmental stages.
Purpose of the Study:
- To establish normal ranges for haemoglobin and ferritin in British children at 12 and 18 months.
- To identify factors associated with these levels.
- To examine correlations between haemoglobin and ferritin concentrations from 8 to 18 months.
Main Methods:
- Utilized data from the
- children in focus
- cohort, a subset of the Avon Longitudinal Study of Pregnancy and Childhood.
- Analyzed capillary blood samples from 940 children at 12 months and 827 at 18 months.
- Employed statistical methods to determine reference ranges and identify associated factors and correlations.
Main Results:
- Haemoglobin and ferritin distributions were determined (normal and log-normal, respectively).
- Established 95% reference ranges for haemoglobin and ferritin.
- Identified associations with sex, maternal education, birth weight, and current weight; noted sex differences in ferritin at 12 months.
- Found significant correlations in haemoglobin and ferritin levels over time (8-18 months).
Conclusions:
- Iron stores are significantly impacted by infant growth.
- Defined anaemia and iron deficiency cut-off points based on the fifth centile.
- Questioned the effectiveness of screening due to variability in children's iron status over time.
Aims:
To define the normal ranges and investigate associated factors for haemoglobin and ferritin in British children at 12 and 18 months of age, and to estimate correlations between both haemoglobin and ferritin concentrations at 8, 12, and 18 months of age.
Subjects And Methods:
Subjects were part of the "children in focus" sample, randomly selected from the Avon longitudinal study of pregnancy and childhood. Capillary blood samples were taken from 940 children at 12 months and 827 children at 18 months of age.
Results:
Haemoglobin was distributed normally and ferritin was distributed log normally at 12 and 18 months of age. Ninety five per cent reference ranges were established from empirical centiles of haemoglobin and ferritin. Haemoglobin concentrations at 18 months were associated with sex and maternal education. Concentrations of ferritin at 12 and 18 months of age were associated with birth weight and current weight. Girls at 12 months, but not at 18 months, had 8% higher ferritin concentrations than boys. Haemoglobin and ferritin concentrations were significantly correlated over time (8-12 months: rHb = 0.26, rFer = 0.46; 12-18 months: rHb = 0.37, rFer = 0.34; 8-18 months: rHb = 0.22, rFer = 0.24).
Conclusion:
Iron stores are depleted by rapid growth in infancy. A definition of anaemia based on the fifth centile gives cut off points at 12 and 18 months of age of haemoglobin < 100 g/l, and for iron deficiency of ferritin < 16 micrograms/l and < 12 micrograms/l, respectively. Because children below the fifth centile at one time point differ from those six months later, it is unclear whether screening would be effective.