Utility of red cell distribution width in screening for iron deficiency

Area of Science:

• Pediatric Hematology
• Nutritional Deficiencies

Background:

• Iron deficiency is a common nutritional deficiency in infants.
• Early detection is crucial for preventing long-term health consequences.
• Standard screening methods may not always identify subclinical iron deficiency.

Purpose of the Study:

• To evaluate the effectiveness of an adult-derived red cell distribution width (RDW) reference limit for detecting iron deficiency in young children.
• To determine the prevalence of non-anemic iron deficiency in 13-month-old infants.

Main Methods:

• Hematological analysis was conducted on a cohort of healthy, 13-month-old term infants.
• Red cell distribution width (RDW) was measured and compared to an adult-derived reference limit (>13.9%).
• Iron deficiency was assessed based on hypochromic red cells, hemoglobin, mean cell volume, mean cell hemoglobin, and zinc protoporphyrin levels.

Main Results:

• 21 out of 98 infants (21.4%) were identified as iron-deficient based on hypochromic red cells.
• Among infants without anemia, 35 with RDW >13.9% showed indicators of incipient iron deficiency compared to those with RDW ≤13.9%.
• These indicators included significantly lower hemoglobin, mean cell volume, and mean cell hemoglobin, along with higher zinc protoporphyrin levels.

Conclusions:

• The adult-derived RDW reference limit demonstrates utility in screening for iron deficiency in 13-month-old infants.
• The study revealed a high incidence of non-anemic iron deficiency (52.8%) in this cohort.
• RDW screening can identify infants with subclinical iron deficiency who may not yet be anemic.