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Published on: January 19, 2024
Population prevalence and risk factors for iron deficiency in Auckland, New Zealand
Cameron C Grant1, Clare R Wall, Deborah Brunt
1Department of Paediatrics, University of Auckland, Auckland, New Zealand. cc.grant@auckland.ac.nz
Insights
Iron deficiency (ID) affects 14% of young children in New Zealand, with prevalence varying by ethnicity. Factors like higher body mass index and not receiving infant formula increase the risk of iron deficiency.
Area of Science:
- Pediatric Nutrition
- Public Health
- Hematology
Background:
- Previous iron deficiency (ID) prevalence estimates in young New Zealand children were limited by sampling bias and imprecise definitions.
- Accurate data is crucial for understanding and addressing nutritional deficiencies in vulnerable populations.
Purpose of the Study:
- To accurately estimate the prevalence of iron deficiency (ID) in children aged 6-23 months in New Zealand.
- To identify factors associated with ID in this age group.
Main Methods:
- An ethnically stratified random sample of 324 children aged 6-23 months in Auckland, New Zealand, enrolled between 1999-2002.
- Exclusion of children with elevated C-reactive protein (>4 mg/L).
- ID defined by two or more abnormal values for serum ferritin, iron saturation, and mean cell volume; analyses adjusted for clustering and weighted for ethnic stratification.
Main Results:
- The prevalence of iron deficiency (ID) was 14% (95% CI 9-17%).
- ID prevalence varied significantly by ethnicity (Maori 20%, Pacific 17%, other 27%, NZ European 7%; P = 0.005) but not social deprivation.
- Increased risk of ID was associated with a body mass index ≥18.5 kg/m² (RR = 4.34) and receiving no infant or follow-on formula (RR = 3.60).
Conclusions:
- Iron deficiency (ID) is prevalent in young New Zealand children, highlighting a significant public health concern.
- Ethnic variations in ID prevalence suggest cultural practices influence iron status.
- Rapid growth and consumption of non-modified milk increase the risk of ID in young children.
Aim:
Previous prevalence estimates of iron deficiency (ID) in young New Zealand children are inaccurate because of sampling bias and imprecise definition of ID. The aim of this study was to estimate the prevalence of ID in children aged 6-23 months and the factors associated with ID.
Methods:
An ethnically stratified sample identified from random residential address start points. Children resident in Auckland, New Zealand were enrolled from 1999 to 2002. Children with elevated C-reactive protein (>4 mg/L) were excluded. Iron status was determined in 324 (78%) of 416 enrolled children. Analyses adjusted for clustering and weighted for ethnic stratification. ID defined as abnormal values for two or more of serum ferritin (<10 microg/L), iron saturation (<10%) and mean cell volume (<73 fl).
Results:
ID was present in 14% (95% confidence interval (CI) 9-17%). ID prevalence varied with ethnicity (Maori 20%, Pacific 17%, other 27%, New Zealand European 7%, P = 0.005), but not with social deprivation. In a multivariate analysis that adjusted for low birthweight, there was an increased risk of ID associated with a body mass index >or= 18.5 kg/m(2) (RR = 4.34, 95% CI 1.08-10.67), and with receiving no infant or follow on formula (RR = 3.60, 95% CI 1.56-6.49).
Conclusions:
ID is prevalent in young New Zealand children. Variance in ID prevalence with ethnicity but not social deprivation implies that cultural practices influence iron status. Young children with more rapid growth are at increased risk of ID as are those receiving milk other than that specifically modified for them.
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