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Updated: Sep 27, 2026
A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Risk factors for iron deficiency in a hospitalized urban New Zealand population
C C Grant1, C R Wall, C Wilson
1Department of Paediatrics, Faculty of Medicine and Health Sciences, University of Auckland, New Zealand. cc.grant@auckland.ac.nz
Insights
Dietary and non-dietary factors increase the risk of iron deficiency anaemia (IDA) and iron deficiency (ID) in hospitalized New Zealand children. Non-dietary factors were more strongly associated with poor iron status than dietary factors in this study.
Area of Science:
- Pediatric Nutrition
- Hematology
- Public Health
Background:
- Iron deficiency anaemia (IDA) and iron deficiency (ID) are significant health concerns in children.
- Understanding associated risk factors is crucial for effective prevention and intervention strategies.
Purpose of the Study:
- To identify dietary practices and sociodemographic factors linked to IDA and ID in hospitalized New Zealand children.
- To differentiate risk factors for IDA versus ID.
Main Methods:
- Prospective study of 391 children aged 8-23 months hospitalized with acute illness.
- Iron deficiency defined by serum ferritin, serum iron saturation, and red cell distribution width.
- IDA defined as ID plus low hemoglobin concentration.
Main Results:
- Pneumonia, Pacific ethnicity, breast milk consumption, maternal meat restriction during pregnancy, and larger household size were associated with increased IDA risk.
- Pacific ethnicity and tea consumption were linked to higher ID risk.
- Gastroenteritis diagnosis was associated with a decreased risk of ID.
Conclusions:
- Both dietary and non-dietary factors contribute to IDA and ID in hospitalized children.
- Non-dietary factors demonstrated a stronger association with poor iron status compared to dietary factors in this cohort.
Objective:
To determine which dietary practices and sociodemographic factors are associated with iron deficiency anaemia (IDA) and iron deficiency (ID) in hospitalized New Zealand children.
Methodology:
A prospective study of children 8-23 months of age hospitalized with an acute illness from 1997 to 1999. Iron deficiency was defined as abnormal values for two out of three of serum ferritin (< 10 micro g/L), serum iron saturation (< 10%) and red cell distribution width (> 14.5%). Iron deficiency anaemia (IDA) was defined as ID + serum haemoglobin concentration <110 g/L. Those with IDA or ID were compared separately with those who were not iron deficient.
Results:
Three hundred and ninety-one children were enrolled. Two hundred and twenty had IDA, 73 had ID and 98 were not iron deficient. In a multivariate analysis, those children who had a diagnosis of pneumonia (odds ratio 4.43, 95% CI 1.49, 13.13) were Pacific (odds ratio 6.31, 95% CI 2.14, 18.63), were currently drinking breast milk (odds ratio 10.22, 95% CI 2.95, 35.42), had a mother who restricted her meat intake during pregnancy (odds ratio 4.40, 95% CI 1.53, 12.64) or lived in a household with more than three children (odds ratio 7.42, 95% CI 1.88, 29.34) were at increased risk of IDA. Those children who were Pacific (odds ratio 5.44, 95% CI 1.37, 21.65) or who drank tea (odds ratio 7.88, 95% CI 1.10, 56.33) were at increased risk of ID. Those with a diagnosis of gastroenteritis (odds ratio 0.16, 95% CI 0.03, 0.75) were at decreased risk of ID.
Conclusions:
Both dietary and non-dietary factors are associated with an increased risk of IDA and ID in New Zealand children. In this hospitalized sample, more non-dietary than dietary factors were associated with poor iron status.
