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Iron deficiency anemia in infants and toddlers
Eun Young Joo1, Keun Young Kim1, Dong Hyun Kim1
1Department of Pediatrics, Inha University College of Medicine, Incheon, Korea.
Insights
Iron deficiency anemia (IDA) is common in Korean children. Low birth weight and prolonged breastfeeding without iron are key risk factors for severe anemia, highlighting the need for early screening and intervention.
Area of Science:
- Pediatrics
- Nutritional Science
- Hematology
Background:
- High prevalence of anemia and iron deficiency anemia (IDA) in Korean infants and young children.
- Need for early detection and intervention to mitigate adverse impacts of IDA.
Purpose of the Study:
- Assess characteristics of infants and young children with IDA or at risk.
- Identify risk factors for severe anemia in this population.
Main Methods:
- Retrospective analysis of medical records and laboratory data.
- Included 1,330 children aged 6-23 months diagnosed with IDA (1996-2013).
- Excluded patients with C-reactive protein ≥5 mg/dL.
Main Results:
- IDA predominantly affected boys (2.14:1); peak incidence at 9-12 months.
- Only 7% of IDA patients showed symptoms; 23.6% of severe IDA patients did.
- Low birth weight (LBW) infants showed poor adherence to iron supplementation.
- Risk factors for severe anemia included prolonged breastfeeding without iron (OR 5.70) and LBW (OR 6.49).
Conclusions:
- LBW infants require increased attention for iron supplementation adherence.
- Recommend evaluating nutritional status and iron levels during health screenings for all infants.
- High-risk infants (LBW, prolonged breastfeeding, picky eaters, symptomatic IDA) need targeted iron assessment.
Background:
In Korea, the prevalence of anemia and iron deficiency anemia (IDA) among older infants and young children remains high. To detect IDA early and to reduce its adverse impact, we assessed the characteristics of infants and young children who had IDA or were at risk of developing IDA, or who exhibited characteristics associated with severe anemia.
Methods:
Among the 1,782 IDA-affected children aged 6 months to 18 years who visited the hospital, we retrospectively analyzed the medical records and laboratory data of 1,330 IDA-affected children aged 6-23 months who were diagnosed between 1996 and 2013. We excluded patients with a C-reactive protein level ≥5 mg/dL.
Results:
IDA was predominant in boys (2.14:1) during infancy and early childhood. The peak IDA incidence was noted among infants aged 9-12 months. Only 7% patients exhibited symptoms of IDA, while 23.6% patients with severe IDA demonstrated classic symptoms/signs of IDA. Low birth weight (LBW) infants with IDA demonstrated low adherence to iron supplementation. In a multivariate analysis, prolonged breastfeeding without iron fortification (odds ratio [OR] 5.70), and a LBW (OR 6.49) were identified as risk factors of severe anemia.
Conclusion:
LBW infants need more attention in order to increase their adherence to iron supplementation. For the early detection of IDA, nutritional status of all infants, and iron batteries of high-risk infants (LBW infants, infants with prolonged breastfeeding, picky eaters, and/or infants with the presence of IDA symptoms) should be evaluated at their health screening visits.
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