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Incidence of iron-deficiency anaemia in infants in a prospective study in Jordan
J Kilbride1, T G Baker, L A Parapia
1Department of Biomedical Sciences, University of Bradford, UK.
Insights
Maternal anemia significantly increases iron-deficiency anemia risk in Jordanian infants. Early detection and intervention are crucial for vulnerable populations in developing countries.
Area of Science:
- Pediatrics
- Hematology
- Public Health
Background:
- Iron-deficiency anemia is prevalent in Jordanian infants.
- Maternal anemia is a potential risk factor for infant iron deficiency.
Purpose of the Study:
- To investigate the relationship between maternal anemia during pregnancy and iron deficiency in infants.
- To assess the prevalence of iron-deficiency anemia in Jordanian infants and evaluate diagnostic criteria.
Main Methods:
- Prospective study of infants born to anemic and non-anemic mothers in Amman.
- Iron status assessed at 3, 6, 9, and 12 months using hemoglobin, plasma ferritin, and zinc protoporphyrin (ZPP).
- Iron-deficiency anemia defined by Hb < 11 g/dl and either plasma ferritin < 12 microg/l or ZPP > 35 microg/dl.
Main Results:
- Overall iron-deficiency anemia prevalence was 72%, significantly higher in infants of anemic mothers (81%) versus controls (65%).
- At 12 months, 72% of infants were anemic.
- Using combined criteria (ferritin or ZPP), 57% were identified as iron-deficient, compared to 37% (ferritin alone) or 40% (ZPP alone).
Conclusions:
- Maternal anemia is a significant risk factor for iron-deficiency anemia in infants.
- Using combined ferritin or ZPP criteria identifies more cases of infant iron deficiency than single markers.
- Infants in developing countries are vulnerable to iron deficiency, necessitating effective diagnostic approaches.
Abstract:
A high prevalence of iron-deficiency anaemia has been reported in Jordanian infants. A prospective study of infants in downtown Amman examined the relationship between anaemia in pregnancy and iron deficiency in infancy. The iron status of infants born to 107 anaemic (Hb < 11 g/dl) and 125 non-anaemic mothers was reviewed at 3, 6, 9 and 12 months. Indicators to define iron-deficiency anaemia were Hb < 11 g/dl and either plasma ferritin < 12 microg/l or zinc protoporphyrin (ZPP) > 35 microg/dl whole blood. Haemoglobin electrophoresis excluded haemoglobinopathy. There was 72% iron-deficiency anaemia throughout the year, significantly higher in infants born to anaemic mothers (81%; n = 91) compared with controls (65%; n = 112). At 12 months, 72% of the infants tested (n = 195) were anaemic. While 57% were identified as iron-deficient by research criteria of either ferritin or ZPP, only 37% were identified by ferritin alone, 40% by ZPP alone and 29% if both ferritin and ZPP were required to meet criteria. Most infant anaemia was identified as due to iron deficiency, supporting contextual setting as assisting diagnosis: infants in developing countries are recognised as vulnerable to iron deficiency. Using multiple criteria, more cases were identified when either ferritin or ZPP were abnormal than when one alone, or both parameters were required to meet research criteria.
